摘要
目的通过对有创机械通气治疗急性呼吸衰竭（呼衰）患者监测指标的分析，探讨氧合指数（PaO2/FiO2）对预后的影响。方法回顾性分析2006年11月至2011年8月兰州军区兰州总医院呼吸内科重症监护病房（ICU）91例急性呼衰行有创机械通气治疗患者的病例资料，根据患者预后分为存活组（55例）和死亡组（36例），比较两组患者通气前病情严重程度评分以及通气过程中血气分析指标的变化，并分析其与患者预后的关系。结果存活组与死亡组患者在通气前急性生理学与慢性健康状况评分系统Ⅲ（APACHEⅢ）评分、多器官功能障碍综合征（MODS）评分、急性肺损伤（Au）评分比较差异均无统计学意义（分：62．77±22．92比74．62±25．77，6．46±2．45比6．62±3．03，1．90±0．57比2．10±0．73，均P〉0．05）。存活组与死亡组患者机械通气1d时PaO2/FiO2（mmHg，1mmHg=0．133kPa）差异无统计学意义（132．18±67．29比139．24±78．36，P〉0．05）；存活组机械通气3d和7d时PaO2/FiO2均较死亡组显著升高（3d：205．47±74．71比149．76±70．38，7d：225．37±67．20比120．94±85．58，P〈0．05和P〈0．01）。结论PaO2/FiO2与急性呼衰行有创机械通气患者的预后相关，连续监测其变化可能作为判断危重病患者预后的参考指标之一。
Objective To investigate the effect of oxygenation index （PaO2/FiO2） on patients＇ prognosis through comparative analyzing the monitoring indicators of acute respiratory failure patients treated by invasive mechanical ventilation. Methods Data from 91 acute respiratory failure patients treated by invasive mechanical ventilation in respiration intensive care unit （ICU） of the General Hospital of PLA of Lanzhou from November 2006 to August 2011 were retrospectively analyzed. Patients were divided into survival group （n=55 ） and death group （n = 36 ） by the outcome, the critical severity scores of the diseases and changes in blood gas analysis during ventilation were compared, and their correlation with prognosis were analyzed. Results There were no significant differences in acute physiology and chronic health evaluation III （APACHE III） score, multiple organ dysfunction syndrome （MODS） score, acute lung injury （ALl） score between survival and death group before ventilation （62.77 ± 22.92 vs. 74.62 ±25.77, 6.46± 2.45 vs. 6.62±3.03, 1.90 ±0.57 vs. 2.10 ± 0.73, all P〉0.05 ）. There was no significant difference in PaO2/FiO2 （mm Hg, 1 mm Hg= 0.133 kPa） between survival and death group on the first day of mechanical ventilation （ 132.18 ± 67.29 vs. 139.24 ± 78.36, P〉0.05 ）. PaO2/FiO2 in survival group were significantly higher than that in death group on the 3 days and 7 days of mechanical ventilation （3 days： 205.47 ± 74.71 vs. 149.76 ± 70.38, 7 days： 225.37 ± 67.20 vs. 120.94± 85.58, P〈0.05 and P〈0.01 ）. Conclusions The present study demonstrated that the level of PaOJFiOz is related with the prognosis of acute respiratory failure patients treated by invasive mechanical ventilation. Continuously monitoring the changes in PaO2/FiO2 can be used as an important reference index to evaluate the prognosis of critical patients.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2012年第10期592-595,共4页
Chinese Critical Care Medicine
基金
全军医药卫生科研基金课题（06G029）
关键词
有创机械通气
呼吸衰竭
急性
氧合指数
预后
Invasive mechanical ventilation
Acute respiratory failure
Oxygenation index
Prognosis
