危重患者在院前转运时血氧饱和度降低的影响因素分析

Analysis of the influencing factors of oxygen saturation decreases in critically ill patients during prehospital transfer time

目的分析危重患者在院前转运的危险因素,为如何有效控制患者血氧饱和度的降低提供科学依据。方法选择2017年1～12月由本院急救科进行转运的190例危重症患者作为本次的研究对象,统计分析性别、年龄、初步诊断、体温、脉搏、血压、呼吸频率、意识状态、SpO_2、改良早期预警评分、转运过程中的供氧装置、转运人员职称、转运时间对患者血氧饱和度的影响,采用Logistic回归进行多因素分析。结果纳入本次研究的190例患者,SpO_2降低> 5%的患者有120例,SpO_2降低≤5%的患者有70例;两组患者的性别及意识状态对SpO2降低无明显影响,差异无统计学意义(P> 0.05);患者的年龄、改良早期预警评分、疾病部位类型、护士职称、转运时间、供氧装置等指标两组相比较,差异均有统计学意义(P <0.05);患者的年龄、改良早期预警评分、护士职称、呼吸系统疾病、供氧装置是导致SpO_2降低的危险因素,差异均有统计学意义(P <0.05)。结论患者的年龄、改良早期预警评分、护士职称、呼吸系统疾病、供氧装置是导致SpO2降低的危险因素,在转运过程中必须针对上诉危险因素进行有效控制,减少患者血氧饱和度的下降。

Objective To analyze the risk factors of prehospital transport in critically ill patients,and to provide scientific basis for how to effectively control the reduction of oxygen saturation in patients. Methods 190 critically ill patients,transferred by the emergency department of our hospital from January 2017 to December 2017 were selected as the objects of this study.Gender,age,preliminary diagnosis,body temperature,pulse,blood pressure,respiratory rate,conscious state,SpO2, improved early warning score,oxygen supply device in the transport process,the title of transport personnel,and the impact of transport time on the patient's blood oxygen saturation were statistically analyzed,using Logistic regression. Results Among the 190 patients included in this study, there were 120 patients whose SpO2 reduced more than 5%,and 70 patients whose SpO2 decreased less than or equal to 5%.Gender and consciousness status of patients in the two groups had no significant influence on the reduction of SpO2,and the difference was not statistically significant (P > 0.05).Age of patients, improved early warning score,nurse's professional title,respiratory diseases, and oxygen supply device were risk factors leading to the reduction of SpO2,and the difference was statistically significant (P < 0.05). Conclusion Patients' age,improved early warning score,nurse professional title,respiratory system disease,oxygen supply device are the risk factors that lead to SpO2 reduction.In the process of transshipment,it is necessary to effectively control the risk factors of appeals to reduce the decrease of blood oxygen saturation.