肥胖对ICU机械通气患者住院死亡的影响研究

发布时间：2018-03-29 13:29

本文选题：重症监护病房　切入点：通气　出处：《中国全科医学》2017年30期

【摘要】：目的观察肥胖对ICU机械通气患者住院死亡的影响。方法选取2015年1—12月连续入住华北理工大学附属医院综合ICU的符合纳入标准的患者210例。参考中国成人体质量判断标准将患者分为肥胖组(n=84)和非肥胖组(n=126)。随访时间截至患者死亡或入ICU后60 d。临床结局指标包括ICU病死率、住院病死率、入ICU 60 d后病死率、机械通气时间、ICU住院时间、总住院时间和并发症发生率(即机械通气21 d、气管再插管、气管切开、呼吸机相关肺炎、中心静脉导管感染、下肢血管血栓发生和压疮)。分析体质指数(BMI)对患者住院死亡的影响。结果本研究无失访、退出和丢失病例。两组患者ICU病死率、住院病死率、入ICU 60 d病死率、气管再插管率、气管切开率、呼吸机相关肺炎发生率、中心静脉导管感染发生率、下肢血管血栓发生率比较,差异无统计学意义(P0.05);肥胖组患者机械通气时间、ICU住院时间、总住院时间长于非肥胖组,机械通气21 d发生率高于非肥胖组(P0.05)。两组患者均未发生压疮。BMI不是ICU机械通气患者住院死亡的独立危险因素[B=0.041,SE=0.035,OR=1.048,95%CI(0.982,1.118),P=0.158]。结论肥胖不是ICU机械通气患者住院死亡的独立影响因素,但其可延长患者的机械通气时间、ICU住院时间和总住院时间。
[Abstract]:Objective to observe the effect of obesity on the in-hospital mortality of ICU patients undergoing mechanical ventilation. Methods 210 patients who were admitted to the General ICU of affiliated Hospital of North China University of Science and Technology from January to December 2015 were selected. The patients were divided into obese group and non-obese group. The follow-up time was 60 days after death or ICU. The clinical outcome included the mortality rate of ICU. Hospital mortality, mortality after 60 days of ICU, duration of mechanical ventilation, total length of stay and incidence of complications (i.e. 21 days of mechanical ventilation, re-intubation of trachea, tracheotomy, ventilator-associated pneumonia, infection of central venous catheter); To analyze the effect of body mass index (BMI) on the death rate of patients in hospital. Results in this study, there were no cases of loss of visit, withdrawal and loss. The mortality of ICU, the mortality of hospitalization, the mortality of 60 days into ICU, and the rate of tracheal re-intubation were analyzed in both groups. The rate of tracheotomy, the incidence of ventilator-associated pneumonia, the incidence of central venous catheter infection, and the incidence of lower extremity vascular thrombosis had no significant difference (P 0.05). The total length of hospitalization was longer than that in the non-obese group. The incidence of mechanical ventilation in 21 days was higher than that in the non-obese group (P 0.05). Neither group had pressure sore. BMI was not an independent risk factor for hospital mortality in patients with ICU. Conclusion Obesity is not an independent risk factor for hospital mortality in ICU patients with mechanical ventilation. But it can prolong the time of mechanical ventilation in ICU and the total hospitalization time.
【作者单位】：河北省秦皇岛市第一医院ICU;华北理工大学附属医院ICU;华北理工大学附属医院呼吸科;
【分类号】：R459.7;R589.2

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