慢性阻塞性肺疾病急性加重期伴呼衰患者有创机械通气撤机拔管影响因素.docVIP

慢性阻塞性肺疾病急性加重期伴呼衰患者有创机械通气撤机拔管影响因素 　　【摘要】 目的：探讨慢性阻塞性肺疾病急性加重期（AECOPD）伴重度呼吸衰竭（呼衰）患者有创机械通气成功撤机拔管的影响因素。方法：回顾性分析2013年1月-2015年6月本院ICU收治的100例接受有创机械通气的AECOPD伴重度呼吸衰竭患者的临床资料，其中成功撤机拔管患者作为有效组，撤机拔管失败和死亡患者作为无效组。对成功撤机拔管影响因素进行单因素分析，采用多因素Logistic回归分析进行独立影响因素分析。结果：单因素分析结果显示：有效组年龄，插管前血红蛋白，插管后血浆白细胞计数、中性粒细胞比率、血红蛋白、白蛋白、C反应蛋白水平，通气时间及器官功能障碍综合征方面均优于无效组，比较差异均有统计学意义（P0.05）；多因素Logistic回归分析结果显示：年龄、插管前HGB、插管后中性粒细胞比率及白蛋白水平、多脏器功能衰竭、机械通气时间为成功撤机拔管的独立影响因素（P0.05）。结论：机械通气是AECOPD伴严重呼衰的有效救治措施，成功撤机拔管的影响因素较多，积极干预影响因素对提高撤机拔管率具有重要临床意义。 　　【关键词】 慢性阻塞性肺疾病； 急性加重； 呼吸衰竭； 有创机械通气； 成功撤机拔管； 护理干预 　　Influence Factors of Withdraw Machine and Extubation in AECOPD and Serious Respiratory Failure Patients Who Underwent Invasive Mechanical Ventilation/CHEN Hong-ju.//Medical Innovation of China，2016，13（06）：048-051 　　【Abstract】 Objective：To investigate the influence factors of successful withdraw machine and extubation in acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and serious respiratory failure patients who underwent invasive mechanical ventilation.Method：The clinical data of 100 cases of AECOPD and serious respiratory failure patients who underwent invasive mechanical ventilation in our hospital from January 2013 to June 2015 were retrospectively analyzed.Patients who successful withdrew machine and extubation were selected as the effective group，patients who were failure to withdraw machine and extubation and death were selected as the invalid group.The single factor analysis was used to analyze the influencing factors of successful withdraw machine and extubation.The independent influencing factors were given the multi-factor Logistic regression analysis.Result：The results of the single factor analysis showed that the age，HGB level before intubation tube，the WBC，NEU%，HBG，ALB，CRP levels at the time of extubation，MODS and ventilation time in the effective group were better than those in the invalid group，the differences were statistically significant（P 　　【Key words】 Chronic obstructive pulmonary