广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2014年
1期
44-46
,共3页
呼吸衰竭%脓毒性休克%血管外肺水指数%老年人
呼吸衰竭%膿毒性休剋%血管外肺水指數%老年人
호흡쇠갈%농독성휴극%혈관외폐수지수%노년인
Respiratory failure%Septic shock%Extravascular lung water index%Elderly
目的：探讨老年呼吸衰竭合并脓毒性休克患者血管外肺水指数（ EVLWI ）的特点及其对死亡的预测价值。方法36例老年呼吸衰竭合并脓毒性休克患者，按其临床结局分为存活组21例和死亡组15例，采用PICCO plus检测仪监测两组患者 EVLWI、全心射血分数（ GEF ）、系统血管阻力（ SVRI ）、中心静脉压（ CVP）、心指数（ CI ）、心率（ HR ）、平均动脉压（ MAP ）并监测 APACHEⅡ评分及血乳酸。结果死亡组APACHEⅡ评分、血乳酸水平、EVLWI高于存活组（P均＜0．05），两组CI、GEF、SVRI、CVP、HR及MAP比较，差异均无统计学意义（P均＞0．05）。描绘EVLWI的ROC曲线发现以EVLWI≥10 ml/kg为界点，预测死亡发生的灵敏度为66．67％，特异度为90．48％，阳性预测值83．33％，阴性预测值79．17％。结论老年呼吸衰竭合并脓毒性休克患者EVLWI明显增高者死亡率高，以EVLWI≥10 ml/kg为界点可作为判断预后不良的指标。
目的：探討老年呼吸衰竭閤併膿毒性休剋患者血管外肺水指數（ EVLWI ）的特點及其對死亡的預測價值。方法36例老年呼吸衰竭閤併膿毒性休剋患者，按其臨床結跼分為存活組21例和死亡組15例，採用PICCO plus檢測儀鑑測兩組患者 EVLWI、全心射血分數（ GEF ）、繫統血管阻力（ SVRI ）、中心靜脈壓（ CVP）、心指數（ CI ）、心率（ HR ）、平均動脈壓（ MAP ）併鑑測 APACHEⅡ評分及血乳痠。結果死亡組APACHEⅡ評分、血乳痠水平、EVLWI高于存活組（P均＜0．05），兩組CI、GEF、SVRI、CVP、HR及MAP比較，差異均無統計學意義（P均＞0．05）。描繪EVLWI的ROC麯線髮現以EVLWI≥10 ml/kg為界點，預測死亡髮生的靈敏度為66．67％，特異度為90．48％，暘性預測值83．33％，陰性預測值79．17％。結論老年呼吸衰竭閤併膿毒性休剋患者EVLWI明顯增高者死亡率高，以EVLWI≥10 ml/kg為界點可作為判斷預後不良的指標。
목적：탐토노년호흡쇠갈합병농독성휴극환자혈관외폐수지수（ EVLWI ）적특점급기대사망적예측개치。방법36례노년호흡쇠갈합병농독성휴극환자，안기림상결국분위존활조21례화사망조15례，채용PICCO plus검측의감측량조환자 EVLWI、전심사혈분수（ GEF ）、계통혈관조력（ SVRI ）、중심정맥압（ CVP）、심지수（ CI ）、심솔（ HR ）、평균동맥압（ MAP ）병감측 APACHEⅡ평분급혈유산。결과사망조APACHEⅡ평분、혈유산수평、EVLWI고우존활조（P균＜0．05），량조CI、GEF、SVRI、CVP、HR급MAP비교，차이균무통계학의의（P균＞0．05）。묘회EVLWI적ROC곡선발현이EVLWI≥10 ml/kg위계점，예측사망발생적령민도위66．67％，특이도위90．48％，양성예측치83．33％，음성예측치79．17％。결론노년호흡쇠갈합병농독성휴극환자EVLWI명현증고자사망솔고，이EVLWI≥10 ml/kg위계점가작위판단예후불량적지표。
Objective To investigate the characteristics and prognostic value of extravascular lung water index ( EVLWI ) for the death in elderly patients with respiratory failure and septic shock .Methods Thirty-six elderly patients with respiratory failure and septic shock were divided into survival group ( 21 patients ) and death group ( 15 patients) according to clinical outcome .All the patients were monitored with pulse indicator continuous cardiac output (PICCO) monitor,and their EVLWI,general ejection fraction (GEF),system vascular resistance index (SVRI),central venous pressure ( CVP ) , cardiac index ( CI ) , heart rate ( HR ) and mean arterial pressure ( MAP ) were collected;The APACHEⅡscore and blood lactate(Lac) and were also recorded .Results APACHEⅡscore,Lac,EVLWI in the death group were significantly higher than those in the survival group (P<0.05),CI,GEF,SVRI,CVP,HR and MAP showed no significant difference between two groups ( all P>0 .05 ) .The ROC curve of EVLWI indicated that EVLWI≥10 ml/kg could be the value of prognosis for death ,and the sensitivity,specificity,positive predictive value,negative predictive value were 66.67%,90.48%,83.33%,79.17% respectively.Conclusion The mortality of elderly patients with respiratory failure and septic shock increases while EVLWI is significantly higher ,EVLWI≥10 ml/kg can be the value of prognosis for death .
