危重症哮喘气管插管机械通气的危险因素分析

Analysis of Risk Factors for Intubation and Mechanical Ventilation in Patients with Severe Asthma

目的研究探讨致危重症哮喘气管插管机械通气的危险因素,加深对此类危重症哮喘的认识和诊治经验。方法回顾性收集分析2010年1月~2013年2月入我院的危重症哮喘患者的临床资料,将其分为气管插管通气组和常规治疗组,分析比较两组的临床资料。结果最终有42例危重症支气管哮喘患者纳入本研究,其中常规治疗者26例(A组),行气管插管机械通气治疗者16例(B组),单因素分析表明B组中既往有气管插管史、激素依赖、依从性差患者所占比例,病死率及并发症发生率均显著高于常规治疗组(<0.05)。糖皮质激素的用量、住院时间也显著高于A组(<0.05),而年龄、性别等因素两组无显著性差异。结论既往有气管插管病史、激素依赖、依从性差可能是导致危重症支气管哮喘气管插管的危险因素,接受气管插管机械通气的患者病情更为危重,病死率高,需引起足够的重视。

Objective To investigate the risk factors for intubation in patients with severe asthma for deepening recognition and therapeutic experience.Methods We retrospectively col ected and analyzed the clinical information of patients with severe asthma admit ed to our hospital from Jan,2010 to Feb,2013.We divided the patients into tow groups,one group is receiving normal treatments(A group),the other is receiving intubation and mechanical ventilation(B group).Clinical data in tow groups were compared and analyzed.Results There were 42 patients included in our study,of them,26 patients who received normal treatments,16 patients who received intubation and mechanical ventilation.Univariate analysis demonstrated that the ratio of history of intubation,steroid dependence,poor compliance,mortality and the rate of complication in group A patients were significantly higher than group B(<0.05).The dosage of steroid and duration of hospitalization in group A patiens were markedly higher than group B(<0.05).There were no significant dif erence in age and gender between tow group.Conclusion History of intubation,corticosteroid dependence and poor compliance maybe the risk factors leading to intubation and receiving mechanical ventilation.Patients with severe asthma who require intubation and mechanical ventilation have higher morbidity,and the condition are more severe.Great at ention should be paid.