摘要
目的分析影响无创正压通气治疗脓毒症致急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)效果的相关因素。方法采用回顾性研究,收集180例脓毒症致ARDS患者的临床资料,均行无创正压通气治疗,采用单因素分析和多因素Logistic回归分析判断影响临床疗效的相关因素。结果180例患者中,治疗有效153例(85.00%),治疗无效27例(15.00%)。相比治疗无效组,治疗有效组血小板计数显著升高,血清降钙素原、C反应蛋白及序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分均显著降低(P<0.05)。相比治疗无效组,治疗有效组氧合指数(rterial partial pressure of oxygen/arterial partial pressure of carbon dioxide,PaO_(2)/FiO_(2))明显升高,转有创正压机械通气的比例明显下降(P<0.05)。经多因素Logistic回归分析发现,血小板计数<50×10^(9)/L、PaO_(2)/FiO_(2)<150、SOFA评分≥10分是影响患者临床疗效的危险因素。结论血小板计数、PaO_(2)/FiO_(2)、SOFA评分均是影响无创正压通气治疗脓毒症致ARDS患者临床效果的相关因素。
Objective To analyze the related factors that affect the efficacy of noninvasive positive pressure ventilation(NPPV)in the treatment of sepsis-induced acute respiratory distress syndrome(ARDS).Methods A retrospective study was performed to collect the clinical data of 180 patients with sepsis-induced ARDS.All patients were treated with NPPV.Univariate analysis and multivariate Logistic regression analysis were used to analyze the related factors affecting the clinical efficacy.Results The treatment was effective in 153(85.00%)of 180 patients but ineffective in the remaining 27(15.00%).Compared with the ineffective treatment group,the platelet count of the effective treatment group was significantly increased,while the serum procalcitonin,C-reactive protein and sequential organ failure assessment(SOFA)score were significantly decreased(P<0.05).Compared with the ineffective treatment group,the oxygenation index(arterial partial pressure of oxygen/arterial partial pressure of carbon dioxide,PaO_(2)/FiO_(2))of the ineffective treatment group was increased significantly,while the proportion of the patients who converted to invasive positive pressure ventilation was decreased significantly(P<0.05).Multivariate logistic regression analysis revealed that platelet count<50×10^(9)/L,PaO_(2)/FiO_(2)<150,and SOFA≥10 were independent risk factors for clinical efficacy.Conclusion Platelet count,PaO_(2)/FiO_(2)and SOFA score are all related factors that affect the clinical efficacy of NPPV in the treatment of sepsis-induced ARDS.
作者
朱琳玲
李平
ZHU Lin-ling;LI Ping(Department of Respiratory and Critical Care Medicine, the First People′s Hospital of Yulin, Guangxi, Yulin 537000, China;Department of Cardiology, the First People′s Hospital of Yulin, Guangxi, Yulin 537000, China)
出处
《河北医科大学学报》
CAS
2021年第3期281-285,共5页
Journal of Hebei Medical University
基金
广西科学研究与技术开发计划项目(桂科攻1598012-4)。
关键词
呼吸窘迫综合征
成人
脓毒症
正压通气
respiratory distress syndrome,adult
sepsis
positive pressure ventilation
