中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2012年
10期
592-595
,共4页
刘杜姣%薛庆亮%王鹿杰%陈卫强%陈伟%于梅
劉杜姣%薛慶亮%王鹿傑%陳衛彊%陳偉%于梅
류두교%설경량%왕록걸%진위강%진위%우매
有创机械通气%呼吸衰竭,急性%氧合指数%预后
有創機械通氣%呼吸衰竭,急性%氧閤指數%預後
유창궤계통기%호흡쇠갈,급성%양합지수%예후
Invasive mechanical ventilation%Acute respiratory failure%Oxygenation index%Prognosis
目的 通过对有创机械通气治疗急性呼吸衰竭(呼衰)患者监测指标的分析,探讨氧合指数(PaO2/FiO2)对预后的影响.方法 回顾性分析2006年11月至2011年8月兰州军区兰州总医院呼吸内科重症监护病房(ICU)91例急性呼衰行有创机械通气治疗患者的病例资料,根据患者预后分为存活组(55例)和死亡组(36例),比较两组患者通气前病情严重程度评分以及通气过程中血气分析指标的变化,并分析其与患者预后的关系.结果 存活组与死亡组患者在通气前急性生理学与慢性健康状况评分系统Ⅲ(APACHEⅢ)评分、多器官功能障碍综合征(MODS)评分、急性肺损伤(ALI)评分比较差异均无统计学意义(分:62.77±22.92比74.62±25.77,6.46±2.45比6.62±3.03,1.90±0.57比2.10±0.73,均P＞0.05).存活组与死亡组患者机械通气ld时PaO2/FiO2(mm Hg,1 mm Hg=0.133 kPa)差异无统计学意义(132.18±67.29比139.24±78.36,P＞0.05)；存活组机械通气3d和7d时PaO2/FiO2均较死亡组显著升高(3 d:205.47±74.71比149.76±70.38,7d:225.37±67.20比120.94±85.58,P＜0.05和P＜0.01).结论 PaO2/FiO2与急性呼衰行有创机械通气患者的预后相关,连续监测其变化可能作为判断危重病患者预后的参考指标之一.
目的 通過對有創機械通氣治療急性呼吸衰竭(呼衰)患者鑑測指標的分析,探討氧閤指數(PaO2/FiO2)對預後的影響.方法 迴顧性分析2006年11月至2011年8月蘭州軍區蘭州總醫院呼吸內科重癥鑑護病房(ICU)91例急性呼衰行有創機械通氣治療患者的病例資料,根據患者預後分為存活組(55例)和死亡組(36例),比較兩組患者通氣前病情嚴重程度評分以及通氣過程中血氣分析指標的變化,併分析其與患者預後的關繫.結果 存活組與死亡組患者在通氣前急性生理學與慢性健康狀況評分繫統Ⅲ(APACHEⅢ)評分、多器官功能障礙綜閤徵(MODS)評分、急性肺損傷(ALI)評分比較差異均無統計學意義(分:62.77±22.92比74.62±25.77,6.46±2.45比6.62±3.03,1.90±0.57比2.10±0.73,均P＞0.05).存活組與死亡組患者機械通氣ld時PaO2/FiO2(mm Hg,1 mm Hg=0.133 kPa)差異無統計學意義(132.18±67.29比139.24±78.36,P＞0.05)；存活組機械通氣3d和7d時PaO2/FiO2均較死亡組顯著升高(3 d:205.47±74.71比149.76±70.38,7d:225.37±67.20比120.94±85.58,P＜0.05和P＜0.01).結論 PaO2/FiO2與急性呼衰行有創機械通氣患者的預後相關,連續鑑測其變化可能作為判斷危重病患者預後的參攷指標之一.
목적 통과대유창궤계통기치료급성호흡쇠갈(호쇠)환자감측지표적분석,탐토양합지수(PaO2/FiO2)대예후적영향.방법 회고성분석2006년11월지2011년8월란주군구란주총의원호흡내과중증감호병방(ICU)91례급성호쇠행유창궤계통기치료환자적병례자료,근거환자예후분위존활조(55례)화사망조(36례),비교량조환자통기전병정엄중정도평분이급통기과정중혈기분석지표적변화,병분석기여환자예후적관계.결과 존활조여사망조환자재통기전급성생이학여만성건강상황평분계통Ⅲ(APACHEⅢ)평분、다기관공능장애종합정(MODS)평분、급성폐손상(ALI)평분비교차이균무통계학의의(분:62.77±22.92비74.62±25.77,6.46±2.45비6.62±3.03,1.90±0.57비2.10±0.73,균P＞0.05).존활조여사망조환자궤계통기ld시PaO2/FiO2(mm Hg,1 mm Hg=0.133 kPa)차이무통계학의의(132.18±67.29비139.24±78.36,P＞0.05)；존활조궤계통기3d화7d시PaO2/FiO2균교사망조현저승고(3 d:205.47±74.71비149.76±70.38,7d:225.37±67.20비120.94±85.58,P＜0.05화P＜0.01).결론 PaO2/FiO2여급성호쇠행유창궤계통기환자적예후상관,련속감측기변화가능작위판단위중병환자예후적삼고지표지일.
Objective To investigate the effect of oxygenation index (PaO2/FiO2) on patients' prognosis through comparative analyzing the monitoring indicators of acute respiratory failure patients treated by invasive mechanical ventilation.Methods Data from 91 acute respiratory failure patients treated by invasive mechanical ventilation in respiration intensive care unit (ICU) of the General Hospital of PLA of Lanzhou from November 2006 to August 2011 were retrospectively analyzed.Patients were divided into survival group (n =55 ) and death group (n =36)by the outcome,the critical severity scores of the diseases and changes in blood gas analysis during ventilation were compared,and their correlation with prognosis were analyzed.Results There were no significant differences in acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ ) score,multiple organ dysfunction syndrome (MODS) score,acute lung injury (ALI) score between survival and death group before ventilation (62.77 ± 22.92 vs.74.62 ± 25.77,6.46 ± 2.45 vs.6.62 ± 3.03,1.90 ± 0.57 vs.2.10 ± 0.73,all P＞0.05 ).There was no significant difference in PaO2/FiO2(mm Hg,1 mm Hg=0.133 kPa) between survival and death group on the first day of mechanical ventilation ( 132.18 ±67.29 vs.139.24 ± 78.36,P＞0.05).PaO2/FiO2 in survival group were significandy higher than that in death group on the 3 days and 7 days of mechanical ventilation (3 days:205.47 ± 74.71 vs.149.76 ± 70.38,7 days:225.37 ± 67.20vs.120.94 ± 85.58,P＜0.05 and P＜0.01 ).Conclusions The present study demonstrated that the level of PaO2/FiO2 is related with the prognosis of acute respiratory failure patients treated by invasive mechanical ventilation.Continuously monitoring the changes in PaO2/FiO2 can be used as an important reference index to evaluate the prognosis of critical patients.
