摘要
目的分析慢性阻塞性肺疾病(COPD)急性加重期患者无创正压通气治疗失败的影响因素,为COPD急性加重期患者无创正压通气治疗提供干预依据。方法收集2017年1月至2020年1月于郑州大学第五附属医院行无创正压通气治疗失败的50例COPD急性加重期患者作为失败组,同期行无创正压通气治疗成功的60例COPD急性加重期患者作为成功组,回顾性分析其临床资料。收集并比较两组性别、年龄、体质指数、格拉斯哥昏迷指数(GCS)评分、改良英国医学研究学会呼吸困难指数(mMRC)分级、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、入院时血生化指标(总蛋白、白蛋白、肌酐)、血常规指标(血红蛋白、白细胞)、肺部感染与否及治疗后1~3 h内呼吸频率、心率、动脉血气指标[pH值、动脉氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数],分析COPD急性加重期患者无创正压通气治疗失败的影响因素。结果经Logistic回归分析显示,APACHEⅡ评分、治疗后呼吸频率、治疗后心率、治疗后动脉血气异常、肺部感染为影响COPD急性加重期患者无创正压通气治疗失败的相关因素(OR>1,P<0.05)。结论COPD急性加重期患者无创正压通气治疗失败可能受APACHEⅡ评分、治疗后呼吸频率、治疗后心率、治疗后动脉血气及肺部感染等因素影响,应引起临床重视。
Objective To analyze the influencing factors of failed non-invasive positive pressure ventilation (NIPPV) treatment for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to provide reference to NIPPV for AECOPD patients.Methods A total of 50 AECOPD patients with NIPPV failure in the Fifth Affiliated Hospital of Zhengzhou University from January 2017 to January 2020 were selected as the failure group, and 60 AECOPD patients with NIPPV success during the same period were selected as the success group. And their clinical data were retrospectively analyzed. The gender, age, body mass index (BMI), Glasgow Coma Scale (GCS) score, modified British Medical Research Council (mMRC) grading, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score, blood biochemical indexes on admission (total protein, albumin, creatinine), blood routine indexes (hemoglobin, white blood cell), pulmonary infection, respiratory rate, heart rate, and arterial blood gas indexes, including pH value, arterial partial pressure of oxygen , arterial partial pressure of carbon dioxide, oxygenation index, after treatment (within 1-3 h) in the two groups were collected and compared. The influencing factors of NIPPV failure in patients with AECOPD were analyzed.Results Logistic regression analysis showed that APACHEⅡ score, postoperative respiratory rate, postoperative heart rate, postoperative abnormal arterial blood gas and pulmonary infection were related influencing factors of NIPPV failure in AECOPD patients (OR>1, P<0.05).Conclusions The failure of NIPPV in patients with AECOPD may be affected by APACHEⅡ score, postoperative respiratory rate, postoperative heart rate, postoperative abnormal arterial blood gas and pulmonary infection, which should be paid clinical attention.
作者
杨默
刘培杰
孙哲
Yang Mo;Liu Peijie;Sun Zhe(Department of General Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2020年第13期25-29,共5页
Chinese Journal of Practical Medicine
关键词
慢性阻塞性肺疾病
急性加重期
无创正压通气
失败
影响因素
Chronic obstructive pulmonary disease,acute exacerbation
Non-invasive positive pressure ventilation
Failure
Influencing factors
