本文關(guān)鍵詞： 重癥急性呼吸窘迫綜合征 氣管插管 低血壓 危險因素 logistic回歸　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探究重癥急性呼吸窘迫綜合征患者氣管插管后發(fā)生低血壓的危險因素,為該病的治療提供理論依據(jù)。方法:選取自2014年2月-2016年2月于我院行氣管插管術(shù)治療的110例重癥急性呼吸窘迫綜合征患者進行研究,根據(jù)其是否發(fā)生低血壓將其分為低血壓組和正常血壓組。其中低血壓組患者34例,收縮壓下降至90mmHg或下降幅度超過40mmHg;正常血壓組患者76例,收縮壓在90mmHg以上(包括90mmHg)并且下降幅度不超過40mmHg(包括40mmHg)。觀察比較兩組患者的一般資料、插管前后的基本生命體征和實驗室指標(biāo),并采用單因素分析確定其危險因素,在此基礎(chǔ)上再采用多因素logistic回歸分析確定危險因素與血壓下降的相關(guān)性。結(jié)果:兩組患者的體重、體重指數(shù)、插管前收縮壓、插管前舒張壓以及插管后舒張壓差異比較,差異顯著,具有統(tǒng)計學(xué)意義(P0.05)。此外,低血壓組患者插管前兩組患者的APACHEⅡ評分無明顯差異(P0.05),插管后差異顯著(P0.05),具有統(tǒng)計學(xué)意義。兩組患者的插管前的血漿白蛋白差異顯著(P0.05),具有統(tǒng)計學(xué)意義(P0.05)。多因素回歸分析結(jié)果顯示,體重、體重指數(shù)、插管前收縮壓、插管前舒張壓以及血漿白蛋白是與插管后低血壓的關(guān)系密切,具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:低體重、低體重指數(shù)、插管前低收縮壓、插管前低舒張壓以及低白蛋白水平均是ARDS患者氣管插管后發(fā)生低血壓的危險因素。因此,急診醫(yī)師應(yīng)在插管前注意危險因素,并采取相關(guān)預(yù)防措施避免插管后低血壓的發(fā)生,提高患者的救治成功率。
[Abstract]:Objective: to investigate the risk factors of hypotension after tracheal intubation in patients with severe acute respiratory distress syndrome. Methods: from February 2014 to February 2016, 110 patients with severe acute respiratory distress syndrome underwent tracheal intubation in our hospital. They were divided into hypotension group and normal blood pressure group according to whether they had hypotension. Among them, 34 patients in hypotension group, systolic blood pressure dropped to 90 mmHg or more than 40 mm Hg, 76 patients in normal blood pressure group, Systolic blood pressure (SBP) was above 90 mmHg (including 90 mmHg) and the decrease was not more than 40 mmHg (including 40mm Hgg). The general data, essential vital signs and laboratory indexes before and after intubation were observed and compared between the two groups, and the risk factors were determined by univariate analysis. Results: body mass index, systolic blood pressure before intubation, diastolic blood pressure before intubation and diastolic blood pressure after intubation were compared between the two groups by multivariate logistic regression analysis. The difference was significant (P 0.05). There was no significant difference in APACHE 鈪，

本文編號：1536086