机械通气治疗慢性阻塞性肺疾病急性加重期患者住院死亡影响因素分析

Analysis on influencing factors of the mechanical ventilation in the treatment of hospital deaths in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者接受机械通气治疗后院内病死率的影响因素。方法回顾性分析2008年7月～2013年3月期间来我院进行有创机械通气的98例AECOPD患者的临床资料．根据患者出院时的具体情况将其分为存活组（58例患者），死亡组（40例患者），采用统计学方法对两组患者的临床资料进行比较。结果①单因素分析结果：死亡组患者的年龄、血清白蛋白水平明屁高于存活组患者．而急性肾功能不全或消化道出血、使用制酸剂、真菌培养阳性及VAP患者在该组所占的比例明显高于存活组患者．两组间差异具有统计学意义（P〈0．05）。②多因素Logistic回归分析结果：院内病死率的危险因素为年龄、急性’肾功能不全或消化道出血。结论年龄及急性肾功能不全或消化道出血为AECOPD患者接受机械通气后院内死亡的危险因素，应采取相应的措施进行干预使患者的预后得到显著的改善。

Objective To investigate the influencing factors of chronic obstructive pulmonary disease with acute exac erbation （AECOPD） in patients receiving mechanical ventilation in the treatment of nosocomial. Methods A retro spective analysis of the clinical data of 98 patients with AECOPD gas collected from July 2008 to March 2013 in our hospital was invasive mechanical ventilation, they were divided into two groups according to the specific circum stances, there were 58 cases in the survival group, there were 40 cases in the death group, we used statistical meth ods to compared the clinical data of two groups. Results （1）The results of single factor analysis ： age, serum albumin level in the death group was significantly higher than the survival group, and the proportion of acute renal failure In complete or hemorrhage of digestive tract, the use of antacids, fungal culture positive and VAP in the death group were significantly higher than that of survival Groups, the differences between the two groups were statistically signif icant （P 〈 0.05 ）. （2） The results of multivariate Logistic regression analysis： risk factors for inhospital mortality were age, acute renal insufficiency or gastrointestinal bleeding. Conclusion Age and acute renal failure all or digestive tract bleeding accepted death risk factors of inhospital mechanical ventilation for AECOPD patients, should take corre sponding measures intervene to the prognosis of the patients improved significantly.