社区获得性肺炎所致脓毒症患者气管插管后低血压危险因素分析

Risk factors of hypotension after tracheal intubation in patients with sepsis caused by community-acquired pneumonia

目的研究EICU社区获得性肺炎所致脓毒症患者实施气管插管后低血压的危险因素,为重症临床工作提供理论依据。方法收集本院急诊重症监护病房(EICU)3年有关社区获得性肺炎所致脓毒症气管插管患者的临床资料进行分析,分为插管后低血压组和插管后血压正常组,采用单因素分析,得出导致插管脓毒症患者出现血压下降的危险因素,在单因素分析的基础上,进行多因素Logistic回归分析确定血压下降与危险因素的相关性。结果 123例患者纳入分析,其中38例气管插管后发生低血压,单因素分析后有5个因素被认为是有意义的,包括插管前收缩压、体重、体重指数、呼吸系统疾病、乳酸等,对单因素分析结果进行Logistic回归分析,插管前收缩压、体重、乳酸为患者气管插管后发生低血压的独立危险因素。结论 EICU社区获得性肺炎所致脓毒症患者气管插管后发生低血压多见于低体重、血压偏低、乳酸高的患者。

Objective To identify the incidence of postintubation hypotension（PIH） in patients with sepsis caused by Community-acquired pneumonia（CAP）and to evaluate the responsive risk factors in EICU. Methods The clinical data of sepsis patients with tracheal intubation caused by community acquired pneumonia in the emergency intensive care unit（EICU）of our hospital were collected and analyzed. The patients were divided into two groups： hypotension group after intubation and normal blood pressure group after intubation. The risk factors of hypotension in sepsis patients with intubation were analyzed by single factor analysis. Based on multivariate Logistic regression analysis, the correlation between blood pressure decline and risk factors was determined. Results 123 patients were included in the study. 38 patients developed hypotension after tracheal intubation. Five factors were considered significant after univariate analysis, including pre-intubation systolic blood pressure, body weight, body mass index, respiratory diseases, lactic acid, etc. Logistic regression analysis was used to analyze the results of univariate analysis. pre-intubation systolic blood pressure, body weight and lactic acid were independent risk factors for hypotension after management. Conclusion PIH is more common in patients with lower body weight,lower systolic pressure and higher lactic acid.