摘要
目的分析慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者接受机械通气治疗后发生肺部感染的特点和危险因素,为机械通气患者的临床诊疗和预防肺部感染提供依据。方法回顾性分析2021年1月至2022年11月368例AECOPD合并Ⅱ型呼吸衰竭患者的临床资料,根据机械通气治疗后是否存在肺部感染分为A组(感染组159例)、B组(未感染组209例),分析患者患有肺部感染的概率,及引发肺部感染的危险因素。结果159例患者存在肺部感染,占比43.21%,其痰液或分泌物培养共分离出178株病原菌。多因素回归分析年龄≥65岁、居住地为农村、具有长期吸烟行为且机体患有3种及以上基础疾病者、切开气管、接受机械通气治疗时间>5 d、存在侵入性操作、吸痰较为频繁是出现肺部感染的危险因素。结论在基础疾病、吸烟等多种因素影响下,AECOPD合并Ⅱ型呼吸衰竭可增加肺部感染发生风险,临床诊疗应采取针对性的应对措施,最大限度降低肺部感染的风险。
Objective To analyze the characteristics and risk factors of pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and type II respiratory failure after mechanical ventilation,so as to provide a basis for the clinical diagnosis and treatment of patients with mechanical ventilation and the prevention of pulmonary infection.Methods The clinical data of 368 patients with AECOPD combined with type II respiratory failure were retrospectively analyzed from January 2021 to November 2022,and the presence or absence of pulmonary infections after mechanical ventilation treatment was divided into group A(159 cases in the infected group)and group B(209 cases in the uninfected group),to analyze the probability that the patients suffered from pulmonary infections and the risk factors that triggered the pulmonary infections.Results 159 cases(43.21%)in the study for the presence of pulmonary infections and a total of 178 pathogenic bacteria were isolated from their sputum or secretion cultures.Multifactorial regression analysis showed that age≥65 years,rural residence,those with chronic smoking behavior and three or more underlying diseases in the organism,incision of the trachea,more than 5 days of mechanical ventilation,presence of invasive procedures,and more frequent aspiration were risk factors for the development of lung infections.Conclusion When AECOPD and type II respiratory failure are combined,the risk of pulmonary infection can be increased under the influence of various factors such as underlying diseases and smoking,and targeted countermeasures should be taken in clinical diagnosis and treatment to minimize the risk of pulmonary infection.
出处
《浙江临床医学》
2024年第8期1187-1189,共3页
Zhejiang Clinical Medical Journal
关键词
慢性阻塞性肺疾病急性加重
呼吸衰竭
机械通气
肺部感染
危险因素
Acute exacerbation of chronic obstructive pulmonary disease
Respiratory failure
Mechanical ventilation
Pulmonary infection
Risk factors
