临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
23期
1932-1935
,共4页
慢性阻塞性肺疾病%有创机械通气%通气时间%相关因素
慢性阻塞性肺疾病%有創機械通氣%通氣時間%相關因素
만성조새성폐질병%유창궤계통기%통기시간%상관인소
Chronic obstructive pulmonary disease%Mechanical ventilation%Duration%Related factors
目的：探讨影响慢性阻塞性肺疾病（ COPD）患者有创机械通气时间的相关因素。方法 COPD患者40例，采取有创机械通气，患者按通气时间长短分为通气短、中、长三组。详细记录患者的性别、年龄、机械通气过程中是否合并上消化道出血情况、发生腹胀情况、一年内COPD急性加重次数、入ICU时APACHEⅡ评分、体质指数（ BMI）、血清生化指标、伴发病、入RICU时胸片是否有渗出病灶、撤机方式等指标。结果在众观察指标中，消化道出血、腹胀、一年内COPD急性加重次数、入ICU时APACHEⅡ评分、BMI、TP、Alb、pre-Alb、Na＋、伴发病糖尿病、心功能不全、入ICU时胸片是否有渗出病灶为与通气时间相关的因素（ P ﹤0.05）。消化道出血、发生腹胀、一年内COPD急性加重次数≥2次、高APACHEⅡ评分、低BMI、低Alb、低pre-Alb、低Na＋、伴发病糖尿病、心功能不全和有渗出病灶为影响COPD患者有创机械通气时间独立危险因素。结论 COPD是一个全身系统疾病，其有创机械通气时间受多种因素影响，针对这些因素采取有效措施干预，有助于缩短机械通气时间。
目的：探討影響慢性阻塞性肺疾病（ COPD）患者有創機械通氣時間的相關因素。方法 COPD患者40例，採取有創機械通氣，患者按通氣時間長短分為通氣短、中、長三組。詳細記錄患者的性彆、年齡、機械通氣過程中是否閤併上消化道齣血情況、髮生腹脹情況、一年內COPD急性加重次數、入ICU時APACHEⅡ評分、體質指數（ BMI）、血清生化指標、伴髮病、入RICU時胸片是否有滲齣病竈、撤機方式等指標。結果在衆觀察指標中，消化道齣血、腹脹、一年內COPD急性加重次數、入ICU時APACHEⅡ評分、BMI、TP、Alb、pre-Alb、Na＋、伴髮病糖尿病、心功能不全、入ICU時胸片是否有滲齣病竈為與通氣時間相關的因素（ P ﹤0.05）。消化道齣血、髮生腹脹、一年內COPD急性加重次數≥2次、高APACHEⅡ評分、低BMI、低Alb、低pre-Alb、低Na＋、伴髮病糖尿病、心功能不全和有滲齣病竈為影響COPD患者有創機械通氣時間獨立危險因素。結論 COPD是一箇全身繫統疾病，其有創機械通氣時間受多種因素影響，針對這些因素採取有效措施榦預，有助于縮短機械通氣時間。
목적：탐토영향만성조새성폐질병（ COPD）환자유창궤계통기시간적상관인소。방법 COPD환자40례，채취유창궤계통기，환자안통기시간장단분위통기단、중、장삼조。상세기록환자적성별、년령、궤계통기과정중시부합병상소화도출혈정황、발생복창정황、일년내COPD급성가중차수、입ICU시APACHEⅡ평분、체질지수（ BMI）、혈청생화지표、반발병、입RICU시흉편시부유삼출병조、철궤방식등지표。결과재음관찰지표중，소화도출혈、복창、일년내COPD급성가중차수、입ICU시APACHEⅡ평분、BMI、TP、Alb、pre-Alb、Na＋、반발병당뇨병、심공능불전、입ICU시흉편시부유삼출병조위여통기시간상관적인소（ P ﹤0.05）。소화도출혈、발생복창、일년내COPD급성가중차수≥2차、고APACHEⅡ평분、저BMI、저Alb、저pre-Alb、저Na＋、반발병당뇨병、심공능불전화유삼출병조위영향COPD환자유창궤계통기시간독립위험인소。결론 COPD시일개전신계통질병，기유창궤계통기시간수다충인소영향，침대저사인소채취유효조시간예，유조우축단궤계통기시간。
Objective To explore the related risk factors for duration of mechanical ventilation in patients with chronic obstructive pulmo_nary disease( COPD). Methods A total of 40 patients with COPD in this hospital were administrated with mechanical ventilation and they were divided into short,medium and long duration groups. The age range,gender ratio,digestive tract bleeding and abdominal distension during me_chanical ventilation,times of acute exacerbation in one year,APACHEⅡscores before entering ICU,BMI,serum biochemical indices,complica_tions,exudative lesions and extubating way were recorded in detail. Results Among these indices,digestive tract bleeding and abdominal disten_sion during mechanical ventilation,times of acute exacerbation in one year,APACHEⅡscores before entering ICU,BMI,total protein( TP),al_bumin( Alb),pre-albumin( pre-Alb),Na+,accompanied with diabetes and cardiac insufficiency and complications were proved to be related factors for duration of mechanical ventilation. Digestive tract bleeding and abdominal distension during mechanical ventilation,acute exacerbation more than 2 times in one year,high APACHEⅡscores before entering ICU,low BMI,low Alb,pre-Alb,Na+,accompanied with diabetes and cardiac insufficiency and complications were independent risk factors for long duration of mechanical ventilation. Conclusion COPD is a systemic disease,and the duration of mechanical ventilation is influenced by many factors,which should be taken into comprehensive consideration. Corre_lated measures should be taken to reduce the duration for mechanical ventilation.
