112例老年慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭机械通气患者肺部感染的危险因素分析

Analysis of Risk Factors for Pulmonary Infection in 112 Elderly AECOPD patients with Type Ⅱ Respiratory Failure

目的:分析老年慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭机械通气患者肺部感染的危险因素。方法:选取2018年1月—2020年2月新乡市第二人民医院接收的112例老年AECOPD合并Ⅱ型呼吸衰竭机械通气患者作为研究对象,回顾性分析患者一般资料,进一步分析老年AECOPD合并Ⅱ型呼吸衰竭机械通气患者肺部感染的危险因素。结果:本组112例老年AECOPD合并Ⅱ型呼吸衰竭机械通气患者,发生肺部感染59例,肺部感染发生率52.68%(59/112)。经单因素分析,老年AECOPD合并Ⅱ型呼吸衰竭机械通气患者肺部感染与性别、年龄、吸烟史、机械通气方式、机械通气时间、频繁吸痰、雾化吸入、营养不良、留置胃管、侵入性操作等因素相关,差异有统计学意义(χ^(2)=7.763、11.115、8.506、22.065、9.101、8.867、14.585、7.763、9.867、8.641,P<0.05)。logistic回归分析显示,年龄、吸烟史、机械通气时间≥1周、侵入性操作、频繁吸痰为肺部感染危险因素。结论:年龄、吸烟史、机械通气时间≥1周、侵入性操作、频繁吸痰均为老年AECOPD合并Ⅱ型呼吸衰竭机械通气患者肺部感染的危险因素,临床需采取有效应对措施,降低肺部感染风险,加速康复进程。

Objective:To analyze the risk factors of pulmonary infection in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with mechanical ventilation of type Ⅱ respiratory failure.Methods:A total of 112 elderly patients with AECOPD combined with type Ⅱ respiratory failure mechanical ventilation who were admitted to the hospital from January 2018 to February 2020 were selected.The general data of the patients were retrospectively analyzed,and the risk factors of pulmonary infection in elderly patients with AECOPD combined with type II respiratory failure and mechanical ventilation were further analyzed.Results:Among the 112 elderly patients with AECOPD combined with type Ⅱ respiratory failure mechanical ventilation,59cases of pulmonary infection occurred,and the incidence of pulmonary infection was 52.68%(59/112).Univariate analysis showed that pulmonary infection in elderly patients with AECOPD complicated with type Ⅱ respiratory failure mechanical ventilation was associated with gender,age,smoking history,mechanical ventilation mode,mechanical ventilation time,frequent sputum suction,aerosol inhalation,malnutrition,indwelling gastric tube,invasive procedures and other factors,the difference was statistically significant(χ^(2)=7.763,11.115,8.506,22.065,9.101,8.867,14.585,7.763,9.867,8.641,P<0.05).Logistic regression analysis showed that age,smoking history,mechanical ventilation time≥1 week,invasive procedures,and frequent sputum suction were risk factors for pulmonary infection.Conclusion:Age,smoking history,mechanical ventilation time≥1 week,invasive operation,and frequent sputum suction are all risk factors for pulmonary infection in elderly patients with AECOPD complicated by type Ⅱ respiratory failure mechanical ventilation.Effective clinical measures should be taken to reduce the risk of pulmonary infection,and to speed up the recovery process.