重症监护病房撤机困难患者短期预后及相关因素分析

发布时间：2018-06-29 02:46

  本文选题：机械通气 + 撤机　； 参考：《广东医学》2016年19期

【摘要】：目的探讨重症监护病房(ICU)撤机困难患者相关危险因素及短期预后。方法回顾性分析ICU收治有创机械通气82例患者的临床资料,根据撤机情况分为撤机成功组和撤机困难组,采用单因素分析筛查出相关变量进行多因素logistic回归分析,判断各因素对撤机困难的影响。结果单因素分析显示,两组患者平均年龄、体质指数、28 d内死亡例数、神经肌肉疾病、恶性肿瘤、重症急性胰腺炎、肾功能不全、心功能不全、精神心理疾病比较差异有统计学意义(P0.05)。撤机前24 h内生理生化指标血清前白蛋白、血肌酐、氧合指数、APACHEⅡ评分比较,差异有统计学意义(P0.05)。多因素分析结果显示年龄、前白蛋白、APACHEⅡ评分、心功能不全进入回归模型(P0.05),是ICU撤机困难患者的影响因素。结论对患者的综合评估是顺利撤机的关键,临床医师的经验也起到重要作用。
[Abstract]:Objective to investigate the risk factors and short-term prognosis of patients with difficult weaning in intensive care unit (ICU). Methods the clinical data of 82 patients with invasive mechanical ventilation were analyzed retrospectively. According to the condition of weaning, the patients were divided into successful weaning group and difficult weaning group. Single factor analysis was used to screen the related variables for multivariate logistic regression analysis. To judge the influence of various factors on the difficulty of machine withdrawal. Results univariate analysis showed that the average age, body mass index (BMI) and death rate within 28 days, neuromuscular disease, malignant tumor, severe acute pancreatitis, renal insufficiency, cardiac insufficiency, and so on. The difference of psychosomatic disease was statistically significant (P0.05). The scores of serum prealbumin, serum creatinine, oxygenation index and Apache 鈪，

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