摘要
目的探讨机械通气后并发急性呼吸窘迫综合征(ARDS)的相关危险因素,为提高机械通气后并发ARDS的诊断及预防提供参考。方法选择2005年12月—2010年6月我院收治的接受机械通气超过48 h的148例患者,根据入院后48 h内有无发生ARDS分为ARDS组(121例)和非ARDS组(27例),对比两组患者的年龄、性别、入院病因、简化急性生理评分(SAPS)、气管切开情况、呼衰指数、pH值、吸气峰值、肺顺应性、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、呼气末正压(PEEP)、部分凝血活酶时间(APTT)、呼吸频率、红细胞计数、肌酐及血糖等17项资料,对结果进行统计学分析。结果对两组患者的年龄、性别、入院病因、SAPS评分以及气管切开情况进行对比后发现,两组各项资料间差异无统计学意义(P>0.05)。两组患者检验指标比较显示,ARDS组患者的呼衰指数、肺顺应性、吸气峰值、PEEP与非ARDS组对比差异有统计学意义(P<0.05)。结论患者肺顺应性、呼衰指数上升,PEEP、吸气峰值升高为导致患者机械通气后发生ARDS的危险因素。
Objective To explore the related risk factors of acute respiratory distress syndrome（ARDS） as complication after mechanical ventilation so as to provide the reference for improvement of diagnosis and prevention of ARDS induced by mechanical ventilation. Methods A total of 148 inpatients underwent mechanical ventilation for more than 48 hours were recruited from December 2005 to June 2010 in our hospital.The patients were divided as ARDS group（n=121） and non-ARDS group（n=27） according to whether they got ARDS during 48 hours mechanical ventilation.The data of the patients between the two groups were comparatively statistically analyzed,including patients′ age,sex,admission etiology,SAPS score,tracheotomy,oxygenation index（PaO2/FiO2）,pH value,peak inspiratory flow（PIF）,pulmonary compliance,PaCO2,PaO2,positive end-expiratory pressure（PEEP）,activated partial thromboplastin time（APTT）,respiratory rate,red blood cell count,creatinine,and glucose. Results The results of comparatively statistically analyses showed that there were no statistical difference in age,sex,admission etiology,SAPS score,and tracheotomy between the two groups（P〉0.05）;but there were statistical difference in PaO2/FiO2,PIF,pulmonary compliance,and PEEP（P〈0.05）. Conclusion The increase of pulmonary compliance and PaO2/FiO2,and increase of PEEP and PIF are the risk factors to the development of ARDS after mechanical ventilation.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第34期3930-3931,3935,共3页
Chinese General Practice
关键词
机械通气
呼吸窘迫综合征
成人
危险因素
Mechanical ventilation
Respiratory distress syndrome
adult
Risk factors
