自发性脑出血后急性呼吸窘迫综合征的发生率及影响因素的研究

The incidence and the root cause analysis of acute respiratory distress syndrome after spontaneous intracerebral hemorrhage

摘要：目的探讨自发性脑出血（ICH）后急性呼吸窘迫综合征（ARDS）的发生率及其高危因素。方法收集广西壮族自治区人民医院重症医学科2000年1月～2012年12月105例需要机械通气的ICH患者，分析其ARDS的发生率及高危因素。结果105例患者纳入研究标准，其中31例患者出现ARDS，发生率为29．52％，高潮气量机械通气患者更易发生ARDS（危险比1．83，95％可信间区1．13～2．82），此外，男性、年龄、吸烟、输用血浆、正液体平衡的患者更易发生ARDS。结论自发性颅内出血后需气管插管机械通气的患者中，出现ARDS较为常见，高潮气量机械通气为发生ARDS的主要高危因素。

Abstract： Objective To investigate the prevalence and risk factors foer acute respiratory distress syn drome （ARDS） after spontaneous intracerebral hemorrhage （ICH）. Methods We collected 105 patients who received mechanical ventilation for spontaneous intracerebral hemorrhage while hospitalized in Intensive Care Unit of People＇s Hospital Guangxi Zhuang Autonomous from January 2000 to December 2012. The incidence and risk factors of acute respiratory distress syndrome were analyzed. Results All 105 patients met the stud- y criteria, 31 patients were proven with acute respiratory distress syndrome. The prevalence of acute respirato- ry distress syndrome was 29.52%, high tidal volume mechanical ventilation was associated with an increased risk of acute respirator distress syndrome （hazard ratio 1.83, 95 CI 1.13 - 2.82）, moreover, male, age, smoking, plasma transfusion, higher fluid balance were risk factors for ARDS. Conclusion Development ofacute respiratory distress syndrome is common after intubation for intracerebral hemorrhage, high tidal volume ventilation is main risk factor for ARDS.