影响重症肺炎机械通气患者脱机失败的危险因素分析及临床预测  

Analysis and clinical prediction of risk factors affecting offline failure mechanical ventilation in patients with severe pneumonia

作　　者：王菁 崔凯[2] 赵晶晶[1] 姚莉[1] WANG Jing;CUI Kai;ZHAO Jingjing;YAO Li(Department of Critical Care Medicine,The Second People′s Hospital of Hefei(Hefei Hospital Affiliated to Anhui Medical University),Hefei,Anhui 230011,China;Department of General Thoracic Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230011,China)

机构地区：[1]合肥市第二人民医院(安徽医科大学附属合肥医院)重症医学科,安徽合肥230011 [2]安徽医科大学第一附属医院普胸外科,安徽合肥230011

出　　处：《临床肺科杂志》2025年第5期744-748,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究影响重症肺炎机械通气患者脱机失败的危险因素并构建列线图模型。方法采用回顾性研究的方法,收集安徽医科大学附属合肥医院2021年1月至2024年8月收住重症医学科的重症肺炎需机械通气患者88例的临床资料,根据患者最终是否脱机分为脱机失败组和脱机成功组,利用相关临床指标进行单因素分析及二分类Logistic回归分析,将有统计学差异的临床指标纳入绘制列线图。结果本研究共纳入重症肺炎机械通气患者88例,其中脱机失败组52例,脱机成功组36例,脱机成功率为40.91%,单因素结果分析提示,年龄、APACHEⅡ评分、氧合指数、白细胞计数、NLR、白蛋白、乳酸脱氢酶、尿酸、PCT差异有统计学意义(P<0.05),将其纳入二分类Logistic回归分析,结果显示年龄、APACHEⅡ评分、NLR、尿酸、PCT是影响重症肺炎机械通气患者脱机失败的危险因素,氧合指数是影响重症肺炎机械通气脱机的保护因素。结论年龄、APACHEⅡ评分、NLR、尿酸、PCT是影响重症肺炎机械通气患者脱机失败的危险因素,氧合指数是影响重症肺炎机械通气脱机的保护因素。Objective To study the risk factors of offline failure in patients with severe pneumonia with mechanical ventilation and construct a nomogram model.Methods The clinical data of 88 patients with severe pneumonia requiring mechanical ventilation admitted to the Department of Intensive Care Medicine of Hefei Hospital Affiliated to Anhui Medical University from January 2021 to August 2024 were collected by retrospective study.The patients were divided into offline failure group and offline success group according to whether they were eventually offline.Relevant clinical indicators were used for univariate analysis and binary Logistic regression analysis,and clinical indicators with statistical differences were included in the graph.Results A total of 88 patients with severe pneumonia were included in this study,including 52 patients in the offline failure group and 36 patients in the offline success group,with a success rate of 40.91%.Univariate analysis showed that age,APACHEII score,oxygenation index,leukocyte,NLR,albumin,lactate dehydrogenase,uric acid and PCT were significantly different(P<0.05).The results showed that age,APACHEⅡscore,NLR,uric acid and PCT were the risk factors for patients with severe pneumonia who were mechanically ventilated,and oxygenation index was the protective factor.Conclusion Age,APACHEⅡscore,NLR,uric acid,and PCT are the risk factors of offline failure in patients with severe pneumonia,and oxygenation index is the protective factor.

关 键 词：重症肺炎 机械通气 脱机 列线图 

分 类 号：R563.1[医药卫生—呼吸系统]