重症急性呼吸窘迫综合征患者气管插管后发生低血压的危险因素logistic回归分析

发布时间：2018-02-26 02:11

  本文关键词： 重症急性呼吸窘迫综合征 气管插管 低血压 危险因素 logistic回归　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探究重症急性呼吸窘迫综合征患者气管插管后发生低血压的危险因素,为该病的治疗提供理论依据。方法:选取自2014年2月-2016年2月于我院行气管插管术治疗的110例重症急性呼吸窘迫综合征患者进行研究,根据其是否发生低血压将其分为低血压组和正常血压组。其中低血压组患者34例,收缩压下降至90mmHg或下降幅度超过40mmHg;正常血压组患者76例,收缩压在90mmHg以上(包括90mmHg)并且下降幅度不超过40mmHg(包括40mmHg)。观察比较两组患者的一般资料、插管前后的基本生命体征和实验室指标,并采用单因素分析确定其危险因素,在此基础上再采用多因素logistic回归分析确定危险因素与血压下降的相关性。结果:两组患者的体重、体重指数、插管前收缩压、插管前舒张压以及插管后舒张压差异比较,差异显著,具有统计学意义(P0.05)。此外,低血压组患者插管前两组患者的APACHEⅡ评分无明显差异(P0.05),插管后差异显著(P0.05),具有统计学意义。两组患者的插管前的血浆白蛋白差异显著(P0.05),具有统计学意义(P0.05)。多因素回归分析结果显示,体重、体重指数、插管前收缩压、插管前舒张压以及血浆白蛋白是与插管后低血压的关系密切,具有统计学意义(P0.05)。结论:低体重、低体重指数、插管前低收缩压、插管前低舒张压以及低白蛋白水平均是ARDS患者气管插管后发生低血压的危险因素。因此,急诊医师应在插管前注意危险因素,并采取相关预防措施避免插管后低血压的发生,提高患者的救治成功率。
[Abstract]:Objective: to investigate the risk factors of hypotension after tracheal intubation in patients with severe acute respiratory distress syndrome. Methods: from February 2014 to February 2016, 110 patients with severe acute respiratory distress syndrome underwent tracheal intubation in our hospital. They were divided into hypotension group and normal blood pressure group according to whether they had hypotension. Among them, 34 patients in hypotension group, systolic blood pressure dropped to 90 mmHg or more than 40 mm Hg, 76 patients in normal blood pressure group, Systolic blood pressure (SBP) was above 90 mmHg (including 90 mmHg) and the decrease was not more than 40 mmHg (including 40mm Hgg). The general data, essential vital signs and laboratory indexes before and after intubation were observed and compared between the two groups, and the risk factors were determined by univariate analysis. Results: body mass index, systolic blood pressure before intubation, diastolic blood pressure before intubation and diastolic blood pressure after intubation were compared between the two groups by multivariate logistic regression analysis. The difference was significant (P 0.05). There was no significant difference in APACHE 鈪，

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