摘要
目的对影响重症加强治疗病房(ICU)患者机械通气时间长短的危险因素进行分析。方法收集中国医科大学附属盛京医院ICU 2011年1月至2011年12月96例使用呼吸机患者的一般情况、原发疾病、机械通气时间、并发症及其开始机械通气时生命体征、生化及影像指标、急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分等指标。将96例患者分为两组,长期机械通气组41例,短期机械通气组55例。所有收集资料通过单因素分析,具有统计学意义者纳入logistic回归分析。结果所有收集资料通过单因素分析结果表明,两组患者的体温、呼吸指数、PaCO2、白细胞数、白蛋白、肌酐、肺动脉楔压、APACHEⅡ、性别、胸片感染像、腹胀、并发症等指标具有显著性差异(P<0.05)。进一步Logistic回归分析结果表明,低白蛋白、高肺动脉楔压、胸片感染像、APACHEⅡ评分、腹胀、出现1种以上并发症为影响机械通气时间的独立影响因素(P<0.05)。结论机械通气患者早期改善营养状态、改善心功能、有效控制感染、保持大便通畅,避免并发症的出现有助于缩短机械通气时间。
Objective To analyze the risk factors for duration of mec hanic al ventilation in critically ill patients.Methods Ninety-six patients who recei ved mechanical ventilation from January 2011 to December 2011 in intensive care unit were recruited in the study.The clinical data were collected retrospectivel y including the general condition,underlying diseases,vital signs before ventilat ion,laboratory examination,and APACHEⅡ score of the patients,etc.According t o ventilation time,the patients were divided into a long-term group（n=41） a nd a short-term group（n=55）.Risk factors were screened by univariate ana lysis,then analyzed by logistic regression method.Results Univaria te analysis revea led that the differences of temperature,respiratory index,PaCO2,white blood c ell count（WBC）,plasma albumin（ALB）,blood urea nitrogen（BUN）,pulmonary art ery wedge pressure（PAWP）,APACHEⅡ,sex,lung infection in X-ray,abdominal distention,and complications between two groups were significant.With logistic multiple regression analysis,the lower level of ALB,higher level of PAWP,lung infection in X-ray,APACHEⅡ score,abdominal distention,and complications we r e independent predictors of long-term mechanical ventilation（P0.05）.Conclusion Early improving the nutritional status and cardi ac function,control infecti on effectively,keep stool patency,and avoid complications may shorten the dura tion of mechanical ventilation in critically ill patients.
出处
《中国呼吸与危重监护杂志》
CAS
2012年第3期235-237,共3页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
机械通气
危险因素
撤机
Mechanical ventilation
Risk factor
Weaning
