摘要
目的探讨Nutritional Risk Screening 2002（NRS2002）对慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）伴Ⅱ型呼吸衰竭患者无创通气治疗临床结局的预测作用。方法本研究采用前瞻性队列研究设计，纳入2010年12月至2012年5月在我科接受无创正压通气（non—invasive positive pressure ventilation，NIPPV）治疗的COPD伴Ⅱ型呼吸衰竭患者233例。对纳入的患者进行入院NRS2002评估，次日进行生化检查，接受NIPPV治疗前、治疗4h后测量血气分析。根据NIPPV治疗结果，将患者分为治疗成功者162例与失败者71例。随访至患者出院。分析NRS2002预测NIPPV治疗的结局。结果多因素分析显示NIPPV治疗前PaCO2、NRS2002评分能正确预测NIPPV治疗失败的76．4％。曲线下面积为0．767，阳性预测值为35．23％，阴性预测值为84．21％。结论临床可根据入院时NRS2002评分及PaCO2水平预测COPD伴Ⅱ型呼吸衰竭患者在普通病房接受NIPPV治疗失败的风险，通过评估结果调整治疗方案。其中NRS2002为预测NIPPV失败提供了无创、简便的方法。
Objective To determine whether Nutritional Risk Screening 2002 （NRS2002） of admission independently predicts outcome of non- invasive positive pressure ventilation （NIPPV） in chronic obstructive pulmonary disease （COPD） patients during hypercapnic respiratory failure. Methods Patients with COPD presenting with hypereapnic respiratory failure at Sichuan University Hospital between December 2010 and May 2012 and receiving NIPPV were studied prospectively. NRS2002 was measured before NIV administration. 233 patients met the inclusion criteria, with NIPPY failed in 71 cases and succeed in 162 cases. The patients were followed up till they were discharged. Results After multivariate Logistic regression, the items such as baseline PaCO2, NRS2002 score could predicted 76.4% of the failure outcome. The area under the curve was 0.767. The positive predictive value was 35.23%. The negative predictive value was 84.21%. Conclusions We can predict the risk failure of NIPPV in patients with COPD and hypereapnic respiratory failure with NRS2002 score and baseline PaCO2, and adjust the treatment project according to the evaluation result. NRS2002 supply non- invasive and portable method for predicting the failure of NIPPV.
出处
《中国实用护理杂志》
北大核心
2014年第19期10-15,共6页
Chinese Journal of Practical Nursing
基金
四川省科技计划项目（2013SZ0001）
关键词
慢性阻塞性肺疾病
无创正压通气
营养风险
临床预测
Chronic obstructive pulmonary disease
Non-invasive positive pressure ventilation
Nutrition screening
Clinical markers
