摘要
目的:探究儿童早期预警评分(paediatric early warning score,PEWS)与急性呼吸窘迫综合征(acute respiratorydistress syndrome,ARDS)患儿行机械通气并发症发生的关系。方法:选取河北北方学院附属第一医院确诊为ARDS并接受机械通气治疗的患儿110例,记录患儿的基线资料、血气分析指标、实验室检测指标、呼吸机参数及小儿危重病例评分(pediatric critical illness score,PCIS)和PEWS。参考患儿通气治疗结果,出现呼吸机相关并发症的患儿纳入试验组(n=20),根据巢式病例对照研究,选择同队列状态良好的患儿作为对照组(n=40)。采用独立样本t检验及多因素logistic回归分析影响患儿通气治疗后并发症发生的因素。结果:对照组与试验组在多器官功能障碍综合症(multipleorgan dysfunction syndrome,MODS)、氧合指数(partial pressure of oxygen/fraction of inspired oxygen,PaO2/FiO2)、二氧化碳分压(partial pressure of carbon dioxide,PaCO2)、血肌酐(serum creatinine,SCr)、血清白蛋白(albumin,ALB)、尿素氮(blood urea nitrogen,BUN)、机械通气时间、平均动脉压(mean article pressure,MAP)、潮气量(tidal volume,VT)、呼气末正压(positive end-expiratory pressure,PEEP)、PCIS和PEWS方面的差异均有统计学意义(均P<0.05)。多因素logistic回归分析进一步提示MODS,PaO2/FiO2,PaCO2,VT,PEEP和PEWS对ARDS患儿机械通气后发生并发症均存在影响(均P<0.05)。结论:MODS,PaO2/FiO2,PaCO2,VT,PEEP和PEWS对ARDS患儿机械通气后发生并发症存在影响。PEWS联合其余指标可评估ARDS患儿机械通气后并发症发生的风险。
Objective:To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS). Methods:A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University,who underwent mechanical ventilation,were selected.The baseline data,blood gas analysis index,laboratory test index,ventilator parameters,pediatric critical illness score (PCIS) and PEWS in the children were recorded.With reference to ventilatory treatment results,the children with ventilator-associated complications were included in the trial group (n=20),while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study.Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment. Results:There were statistically significant differences in multiple organ dysfunction syndrome (MODS),partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2),partial pressure of carbon dioxide (PaCO2),serum creatinine (SCr),albumin (ALB),blood urea nitrogen (BUN), mechanical ventilation time,mean article pressure (MAP),tidal volume (VT),positive endexpiratory pressure (PEEP),PCIS,PEWS between the control group and the experimental group (all P<0.05).Multivariate logistic regression analysis showed that MODS,PaO2/FiO2,PaCO2,VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05). Conclusion:The MODS,PaO2/FiO2,PaCO2,VT,PEEP,and PEWS exert effects on complications after mechanical ventilation in children with ARDS.PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.
作者
卢艳辉
刘振奎
李世阳
王艳飞
李春梅
袁二伟
邢静
郭卫平
LU Yanhui;LIU Zhenkui;LI Shiyang;WANG Yanfei;LI Chunmei;YUAN Erwei;XING Jing;GUO Weiping(Department of Pediatrics,First Affiliated Hospital of Hebei North University,Zhangjiakou Hebei 075000,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2019年第9期996-1002,共7页
Journal of Central South University ：Medical Science
基金
河北省张家口市科技攻关计划项目(1521096D)~~
