摘要
目的 筛选老年患者长期机械通气 (PMV)的影响因素。 方法 收集 15 4例肺部感染或慢性阻塞性肺疾病 (COPD)急性加重患者 ,在机械通气 (简称通气 )前及撤机或通气 2 1d时的各项指标。 结果 单因素分析结果表明 :年龄、是否卧床、白细胞数、中性粒细胞比例、肺泡 动脉血氧分压差〔P(A a) O2 〕、尿素氮、肌酐、上消化道出血、心率、血压 ,短期通气组撤机时或PMV组通气 2 1d时上述指标及心功能、意识状态为PMV的影响因素。多因素分析结果表明 :与PMV相关的独立因素为年龄、通气 2 1d时P(A a) O2 及心功能 ;年龄≥ 82 0岁、通气 2 1d时P(A a) O2 ≥ 95 0mmHg、心功能≥3级为PMV的危险因素。随后检验 8例PMV患者 ,同时满足 3项指标判定PMV的准确性为87 5 %。 结论 年龄、通气 2 1d时P(A a) O2 及心功能为影响PMV的独立因素。
Objective To screen the influencing factors related to prolonged mechanical ventilation (PMV). Methods Series of parameters of 154 elderly patients with pneumonia or COPD exacerbation were collected before using ventilator, after weaning of ventilator or at the 21st day of ventilating, respectively. Results By single factor analysis, PMV related to not only age, lying on bed, white blood cell, neutrophil, P (A-a)O 2, BUN, Cr, upper digestive tract bleeding, heart rate(HR), and blood pressure(BP) before using ventilator, but also related to heart function and consciousness after ventilator weaning or ventilating for 21 days. By multiple factor analysis, age, P (A-a) O 2 , heart function when ventilating for 21 days were related to PMV. Age≥82.0, P (A-a)O 2 ≥95.0 mm Hg, heart function≥grade 3 were high risk factors of PMV. Furthermore, it was found that the accuracy rate for meeting with those three parameters among 8 elderly patients with PMV was 87.5%. Conclusions Age, P (A-a)O 2 and heart function when ventilating for 21 days might be the independent factors of PMV.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2004年第5期300-303,共4页
Chinese Journal of Geriatrics
