中国实用护理杂志
中國實用護理雜誌
중국실용호리잡지
CHINESE JOURNAL OF PRACTICAL NURSING
2014年
19期
10-15
,共6页
慢性阻塞性肺疾病%无创正压通气%营养风险%临床预测
慢性阻塞性肺疾病%無創正壓通氣%營養風險%臨床預測
만성조새성폐질병%무창정압통기%영양풍험%림상예측
Chronic obstructive pulmonary disease%Non-invasive positive pressure ventilation%Nutrition screening%Clinical markers
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.
目的 探討Nutritional Risk Screening 2002(NRS2002)對慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴Ⅱ型呼吸衰竭患者無創通氣治療臨床結跼的預測作用.方法 本研究採用前瞻性隊列研究設計,納入2010年12月至2012年5月在我科接受無創正壓通氣(non-invasive positive pressure ventilation,NIPPV)治療的COPD伴Ⅱ型呼吸衰竭患者233例.對納入的患者進行入院NRS2002評估,次日進行生化檢查,接受NIPPV治療前、治療4h後測量血氣分析.根據NIPPV治療結果,將患者分為治療成功者162例與失敗者71例.隨訪至患者齣院.分析NRS2002預測NIPPV治療的結跼.結果 多因素分析顯示NIPPV治療前PaCO2、NRS2002評分能正確預測NIPPV治療失敗的76.4％.麯線下麵積為0.767,暘性預測值為35.23％,陰性預測值為84.21％.結論 臨床可根據入院時NRS2002評分及PaCO2水平預測COPD伴Ⅱ型呼吸衰竭患者在普通病房接受NIPPV治療失敗的風險,通過評估結果調整治療方案.其中NRS2002為預測NIPPV失敗提供瞭無創、簡便的方法.
목적 탐토Nutritional Risk Screening 2002(NRS2002)대만성조새성폐질병(chronic obstructive pulmonary disease,COPD)반Ⅱ형호흡쇠갈환자무창통기치료림상결국적예측작용.방법 본연구채용전첨성대렬연구설계,납입2010년12월지2012년5월재아과접수무창정압통기(non-invasive positive pressure ventilation,NIPPV)치료적COPD반Ⅱ형호흡쇠갈환자233례.대납입적환자진행입원NRS2002평고,차일진행생화검사,접수NIPPV치료전、치료4h후측량혈기분석.근거NIPPV치료결과,장환자분위치료성공자162례여실패자71례.수방지환자출원.분석NRS2002예측NIPPV치료적결국.결과 다인소분석현시NIPPV치료전PaCO2、NRS2002평분능정학예측NIPPV치료실패적76.4％.곡선하면적위0.767,양성예측치위35.23％,음성예측치위84.21％.결론 림상가근거입원시NRS2002평분급PaCO2수평예측COPD반Ⅱ형호흡쇠갈환자재보통병방접수NIPPV치료실패적풍험,통과평고결과조정치료방안.기중NRS2002위예측NIPPV실패제공료무창、간편적방법.
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 hypercapnic 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 NIPPV 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 hypercapnic 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.
