慢性阻塞性肺疾病患者重症监护期间机械通气时间影响因素分析.docVIP

慢性阻塞性肺疾病患者重症监护期间机械通气时间影响因素分析 　　[摘要] 目的 汇总分析慢性阻塞性肺疾病（COPD）患者重症监护期间机械通气时间相关影响因素，为该类疾病的临床治疗提供参考。 方法 以徐州矿务集团总医院重症医学科于2012年3月～2014年5月收治并进行机械通气的84例COPD患者为研究对象，依据机械通气时间分为A组（机械通气时间不超过7 d）和B组（机械通气时间大于7 d）。汇总分析两组患者插管前后的临床资料，分析影响机械通气时间的相关因素。 结果 插管前A、B两组患者在年龄、心率、血清白蛋白、前白蛋白方面差异有统计学意义（P 0.05），插管后在消化道出血和呼吸机相关性肺炎方面差异有统计学意义（P 0.05）。Logistic回归分析结果显示，患者血清白蛋白水平、前白蛋白水平、消化道出血和呼吸机相关性肺炎是影响机械通气时间的独立危险因素（P 0.05）。 结论 血清白蛋白水平、前白蛋白水平、消化道出血和呼吸机相关性肺炎等为延长COPD患者机械通气时间的独立危险因素，临床应给予高度重视。 　　[关键词] 慢性阻塞性肺疾病；机械通气时间；危险因素 　　[中图分类号] R563.9 [文献标识码] A [文章编号] 1673-7210（2015）01（b）-0065-04 　　[Abstract] Objective To analyze the influence factors of mechanical ventilation duration of COPD patients in intensive care， expect to provide a reference for the treatment of COPD. Methods 84 cases of COPD patients were selected as the objects of the study， who were treated in Department of Critical Care Medicine， Xuzhou Mining Group General Hospital from March 2012 to May 2014. All the patients were divided into group A （mechanical ventilation time ≤ 7 days） and group B （mechanical ventilation time 7 days）， summarized the clinical data before and after intubation， analyzed the influence factors of mechanical ventilation duration. Results The age， heart rate， serum albumin， prealbumin between group A and group B before intubation had statistically significant differences （P 0.05）. After intubation， the incidence of gastrointestinal bleeding and ventilator associated pneumoniain between group A and group B had statistically significant differences （P 0.05）. The results of Logistic analysis showed that serum albumin level， prealbumin level， gastrointestinal bleeding and ventilator-associated pneumonia were the independent risk factors of mechanical ventilation duration （P 0.05）. Conclusion The serum albumin level， prealbumin level， gastrointestinal bleeding and ventilator-associated pneumonia were the independent risk factors for prolonging the of mechanical ventilation duration. Clinic should pay more attention on