急性脑出血并呼吸衰竭患者继发多器官功能衰竭的危险因素分析

Risk factors of multiple organ failure in patients with acute cerebral hemorrhage and respiratory failure

目的分析探讨急性脑出血并呼吸衰竭患者继发多器官功能衰竭的危险因素。方法选取2018年4月至2020年4月期间本院收治的急性脑出血并呼吸衰竭患者109例为研究对象,统计患者在治疗期间继发MOF的发生率。根据患者MOF发生情况将109例患者分为MOF发生组和未发生组,对两组急性脑出血并呼吸衰竭患者的各项资料和临床数据进行对比分析,并以单因素和Logistic多因素分析探讨影响急性脑出血并呼吸衰竭患者继发MOF的危险因素。结果109例患者中共有35例继发MOF,发生率为32.11%。经单因素分析,两组患者的性别、体质指数(BMI)、吸烟史、饮酒史、收缩压(SBP)、舒张压(DBP)、出血部位等对比无显著差异(P>0.05),MOF发生组患者的年龄、急性生理学与慢性健康评分(APACHEⅡ)、出血量、基础疾病发生率、有创机械通气率均高于未发生组(P<0.05)。经多因素分析,高龄、APACHEⅡ评分>15分、出血量>50mL、合并基础疾病、有创机械通气是急性脑出血并呼吸衰竭继发MOF的高危因素。结论急性脑出血并呼吸衰竭患者有较高的多器官功能衰竭的发生率,进一步加重患者的生命危险。其中高龄、APACHEⅡ评分>15分、出血量>50mL、合并基础疾病、有创机械通气是急性脑出血并呼吸衰竭继发MOF的危险因素。

Objective To analyze the risk factors of multiple organ failure(MOF)in patients with acute cerebral hemorrhage and respiratory failure.Methods 109 patients with acute cerebral hemorrhage and respiratory failure admitted to our hospital from April 2018 to April 2020 were selected as the research objects,and the incidence of secondary MOF in patients during the treatment period was counted.According to the incidence of MOF,109 patients were divided into MOF group and non MOF group.The data and clinical data of two groups of patients with acute cerebral hemorrhage and respiratory failure were compared and analyzed.The risk factors of secondary MOF in patients with acute cerebral hemorrhage and respiratory failure were analyzed by univariate and logistic multivariate analysis.Results There were 35 cases of secondary MOF in 109 patients,the incidence was 32.11%.By univariate analysis,there were no significant differences in gender,body mass index(BMI),smoking history,drinking history,systolic blood pressure(SBP),diastolic blood pressure(DBP)and bleeding site between the two groups(P>0.05).The age,APACHEⅡ,bleeding volume,incidence of basic diseases and invasive mechanical ventilation rate in MOF group were higher than those in non MOF group(P<0.05).By multivariate analysis,the risk factors of MOF secondary to acute cerebral hemorrhage and respiratory failure were age,APACHEⅡscore>15,blood loss>50 mL,basic diseases and invasive mechanical ventilation.Conclusions Patients with acute cerebral hemorrhageand respiratory failure have a higher incidence of multiple organ failure,which further aggravates the life risk of patients.The risk factors of MOF secondary to acute cerebral hemorrhage and respiratory failure were old age,APACHEⅡscore>15,blood loss>50 mL,basic diseases and invasive mechanical ventilation.