急性左心衰竭患者无创机械通气失败的影响因素分析

Analysis of the factors affecting noninvasive mechanical ventilation failure in patients with acute left heart failure

目的探讨急性左心衰竭患者无创机械通气失败的影响因素。方法选取2019年1月至2020年12月萍乡矿业集团有限责任公司总医院收治的90例急性左心衰竭患者,根据治疗效果分为治疗良好组(47例)和治疗失败组(43例)。统计两组临床基本资料并进行单因素分析,对其中差异有统计学意义的因素进行多因素logistic回归分析筛选独立危险因素。结果单因素分析结果显示,面罩漏气、面部压迫性损伤情况、腹胀、使用方法不当、代谢性并发症发生、治疗前pH值、中性粒细胞占白细胞百分比为影响无创机械通气失败的相关因素(P<0.05);多因素回归分析结果显示,面罩漏气、面部压迫性损伤、腹胀、使用方法不当、发生代谢性并发症均为急性左心衰竭患者不良无创机械通气失败的独立危险因素(P<0.05)。结论面罩漏气、面部压迫性损伤、腹胀、使用方法不当、发生代谢性并发症均为急性左心衰竭患者无创机械通气失败的影响因素,临床需对其影响因素进行早期风险评估与防治,提高治疗效果。

Objective To explore the influencing factors of noninvasive mechanical ventilation failure in patients with acute left heart failure.Methods A total of 90 patients admitted to the General Hospital of Pingxiang Mining Group Co.,Ltd from January 2019 to December 2020 were selected and were divided into good treatment group(47 cases)and treatment failure group(43 cases)according to the treatment effect.Basic clinical data of both groups were counted and underwent univariate analysis,multivariate and statistically significant factors were analyzed for logistic regression to screen for independent risk factors.Results The univariate analysis results showed that air mask leakage,facial compression injury,abdominal distension,improper use method,occurrence of metabolic complications,pH,neutrophils as the percentage of leukocytes were related factors affecting the failure of non-invasive mechanical ventilation(P<0.05).The multivariate regression analysis showed that mask leakage,facial compression injury,abdominal distension,improper use,and metabolic complications were independent risk factors for poor noninvasive mechanical ventilation failure in acute left heart failure(P<0.05).Conclusion Air mask leakage,facial compression injury,abdominal distension,improper use methods,and metabolic complications are all the influencing factors of noninvasive mechanical ventilation failure in patients with acute left heart failure.Clinically,early risk assessment and prevention of the influencing factors are needed to improve the treatment effect.