摘要
目的比较分析影响ICU病房慢性阻塞性肺疾病（COPD）患者预后的因素。方法将入住ICU的45例COPD合并急性呼吸衰竭患者按生存和死亡分为生存组（26例）与死亡组（19例），详细记录患者的年龄、性别、ICU入住首日急性生理学参数及生化指标，并评估APACHEⅡ、APAcHEⅢ两种评分方法及格拉斯哥昏迷量表（GCS）测定患者的昏迷程度，观察2组患者ICU滞留时间、入院24h内是否需要机械通气、合并疾病的有无以及结局（生存、死亡）。结果死亡组患者的平均动脉压（MAP）、GCS得分、呼吸频率（RR）均明显低于生存组，而血肌酐、APACHEⅢ评分均高于生存组（均P〈0．05），差异均有统计学意义。结论患者入住ICU首日MAP、RR的下降以及血肌酐水平升高和高的APACHEⅢ评分对入住ICU中COPD合并急性呼吸衰竭患者生存预后有预测价值。
Objective To compare prognostic factors of chronic obstructive pulmonary disease （COPD） in an intensive care unit （ ICU ）. Methods Forty-five COPD patients with acute respiratory failure （ARF） were divided into survlvors （ n = 26 ） and nonsurvivors （ n = 19 ）. Age, sex, first-ICU-day, acute physiology and chronic health evaluation （APACHE ） Ⅱ, Ⅲscores and Glasgow coma scores {GCS ）, length of ICU stay, mechanical ventilation （ MV ） requirement during the first 24 hours, coexisting illnesses and outcome were recorded for each patient. Results Mean arterial pressure （ MAP ） , GCS and respiratory rate （ RR ） were lower in the nonsurvivors while creatinine and APACHE Ⅲ scores were higher than in survivors group （ P 〈 0.05 ）. Conclusion Lower MAP and RR ;higher creatinine and APACHE III scores are thought to be associated with poor survival in patients with COPD suffering from ARF.
出处
《中国综合临床》
北大核心
2008年第2期148-150,共3页
Clinical Medicine of China
关键词
慢性阻塞性肺疾病
急性呼吸衰竭
预后
Chronic obstructive pulmonary disease
Acute respiratory failure
Prognosis
