重癥監(jiān)護病房撤機困難患者短期預后及相關(guān)因素分析
發(fā)布時間:2018-06-29 02:46
本文選題:機械通氣 + 撤機 ; 參考:《廣東醫(yī)學》2016年19期
【摘要】:目的探討重癥監(jiān)護病房(ICU)撤機困難患者相關(guān)危險因素及短期預后。方法回顧性分析ICU收治有創(chuàng)機械通氣82例患者的臨床資料,根據(jù)撤機情況分為撤機成功組和撤機困難組,采用單因素分析篩查出相關(guān)變量進行多因素logistic回歸分析,判斷各因素對撤機困難的影響。結(jié)果單因素分析顯示,兩組患者平均年齡、體質(zhì)指數(shù)、28 d內(nèi)死亡例數(shù)、神經(jīng)肌肉疾病、惡性腫瘤、重癥急性胰腺炎、腎功能不全、心功能不全、精神心理疾病比較差異有統(tǒng)計學意義(P0.05)。撤機前24 h內(nèi)生理生化指標血清前白蛋白、血肌酐、氧合指數(shù)、APACHEⅡ評分比較,差異有統(tǒng)計學意義(P0.05)。多因素分析結(jié)果顯示年齡、前白蛋白、APACHEⅡ評分、心功能不全進入回歸模型(P0.05),是ICU撤機困難患者的影響因素。結(jié)論對患者的綜合評估是順利撤機的關(guān)鍵,臨床醫(yī)師的經(jīng)驗也起到重要作用。
[Abstract]:Objective to investigate the risk factors and short-term prognosis of patients with difficult weaning in intensive care unit (ICU). Methods the clinical data of 82 patients with invasive mechanical ventilation were analyzed retrospectively. According to the condition of weaning, the patients were divided into successful weaning group and difficult weaning group. Single factor analysis was used to screen the related variables for multivariate logistic regression analysis. To judge the influence of various factors on the difficulty of machine withdrawal. Results univariate analysis showed that the average age, body mass index (BMI) and death rate within 28 days, neuromuscular disease, malignant tumor, severe acute pancreatitis, renal insufficiency, cardiac insufficiency, and so on. The difference of psychosomatic disease was statistically significant (P0.05). The scores of serum prealbumin, serum creatinine, oxygenation index and Apache 鈪,
本文編號:2080490
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