序贯机械通气治疗AECOPD伴呼吸衰竭的成功率及失败因素分析(1)
【摘要】 目的：探討序贯机械通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)伴呼吸衰竭的成功率及失败因素。方法：选取2017年6月-2019年6月进入本院接受序贯机械通气治疗的60例AECOPD伴呼吸衰竭患者，统计序贯机械通气治疗7 d内的治疗成功率，记录并分析可能引发序贯机械通气治疗AECOPD伴呼吸衰竭的失败因素。结果：60例实施序贯机械通气治疗AECOPD伴呼吸衰竭患者中，治疗成功者49例，治疗成功率为81.67%(49/60)。两组性别、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)比较，差异均无统计学意义(P>0.05);两组年龄、营养状况、原发病控制、急性生理与慢性健康(APACHE)Ⅱ评分、肺/升比值、脑钠肽(BNP)水平、白细胞计数(WBC)、降钙素原(PCT)水平、血浆前白蛋白水平比较，差异均有统计学意义(P<0.05);经Logistic回归分析显示，年龄(≥60岁)、营养状况(不良)、原发病控制(不良)、APACHEⅡ评分、肺/升比值、BNP水平、WBC水平、PCT水平、血浆前白蛋白水平均是引起机械通气治疗失败的独立危险因素(OR>1，P<0.05)。结论：年龄、营养状况不良、原发病控制不良、APACHEⅡ评分、肺/升比值、BNP、WBC、PCT、血浆前白蛋白水平均是引起机械通气治疗失败的独立危险因素，在进行通气治疗时需密切关注上述指标，以期提升治疗成功率。
【关键词】 阻塞性肺疾病急性加重期 呼吸衰竭 序贯机械通气治疗 成功率 失败因素
[Abstract] Objective： To investigate the success rate and failure factors of sequential mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure. Method： From June 2017 to June 2019， 60 patients with AECOPD and respiratory failure who were admitted to our hospital for sequential mechanical ventilation treatment were selected. The success rate of sequential mechanical ventilation treatment within 7 d was counted， and the failure factors that may lead to sequential mechanical ventilation treatment of AECOPD and respiratory failure were recorded and analyzed. Result： Of the 60 patients with AECOPD and respiratory failure who were treated by sequential mechanical ventilation， 49 were successful， and the success rate was 81.67% (49/60). There were no significant differences in gender， arterial blood carbon dioxide partial pressure (PaCO2)， arterial blood oxygen partial pressure (PaO2) between the two groups (P>0.05); age， nutritional status， primary disease control， acute physiology and chronic health (APACHE) Ⅱ score， lung/liter ratio， brain natriuretic peptide (BNP) level， white blood cells count (WBC)， procalcitonin (PCT) level and plasma prealbumin level were compared between the two groups， the differences were statistically significant (P<0.05). Logistic regression analysis showed that age (≥60 years old)， nutritional status (poor)， primary disease control (poor)， APACHEⅡ score， lung/liter ratio， BNP level， WBC level， PCT level and plasma prealbumin level were all independent risk factors (OR>1， P<0.05). Conclusion： Age， malnutrition， primary disease control， APACHEⅡ score， lung/liter ratio， BNP， WBC， PCT and prealbumin were all independent risk factors for failure of mechanical ventilation， in order to improve the success rate of ventilation treatment， we should pay close attention to the above indicators., http://www.100md.com(黄影兰 欧少佳 陈卓莲 陈文智)
【关键词】 阻塞性肺疾病急性加重期 呼吸衰竭 序贯机械通气治疗 成功率 失败因素
[Abstract] Objective： To investigate the success rate and failure factors of sequential mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure. Method： From June 2017 to June 2019， 60 patients with AECOPD and respiratory failure who were admitted to our hospital for sequential mechanical ventilation treatment were selected. The success rate of sequential mechanical ventilation treatment within 7 d was counted， and the failure factors that may lead to sequential mechanical ventilation treatment of AECOPD and respiratory failure were recorded and analyzed. Result： Of the 60 patients with AECOPD and respiratory failure who were treated by sequential mechanical ventilation， 49 were successful， and the success rate was 81.67% (49/60). There were no significant differences in gender， arterial blood carbon dioxide partial pressure (PaCO2)， arterial blood oxygen partial pressure (PaO2) between the two groups (P>0.05); age， nutritional status， primary disease control， acute physiology and chronic health (APACHE) Ⅱ score， lung/liter ratio， brain natriuretic peptide (BNP) level， white blood cells count (WBC)， procalcitonin (PCT) level and plasma prealbumin level were compared between the two groups， the differences were statistically significant (P<0.05). Logistic regression analysis showed that age (≥60 years old)， nutritional status (poor)， primary disease control (poor)， APACHEⅡ score， lung/liter ratio， BNP level， WBC level， PCT level and plasma prealbumin level were all independent risk factors (OR>1， P<0.05). Conclusion： Age， malnutrition， primary disease control， APACHEⅡ score， lung/liter ratio， BNP， WBC， PCT and prealbumin were all independent risk factors for failure of mechanical ventilation， in order to improve the success rate of ventilation treatment， we should pay close attention to the above indicators., http://www.100md.com(黄影兰 欧少佳 陈卓莲 陈文智)
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