重症肺炎无创机械通气患者发生腹胀的影响因素

Influencing factors of abdominal distension in patients with severe pneumonia undergoing noninvasive mechanical ventilation

目的分析重症肺炎无创机械通气患者发生腹胀的影响因素。方法抽取2018年10月至2020年10月河南医学高等专科学校附属医院收治的130例重症肺炎患者作为研究对象, 统计所有患者无创机械通气后腹胀的发生情况并分组;设计基线资料填写表, 纳入可能的影响因素, 找出重症肺炎无创机械通气患者发生腹胀的危险因素。结果 130例重症肺炎患者中发生腹胀53例(40.77%), 未发生腹胀77例(59.23%)。发生组气囊充气不足、合并低血钾者占比(50.94%, 27/53;35.85%, 19/53)高于未发生组(29.87%, 23/77;15.58%, 12/77), P<0.05;发生组无创机械通气时间长于未发生组, 白细胞介素-6(IL-6)水平高于未发生组, 前白蛋白(PAB)水平低于未发生组(P<0.05)。Logistic回归分析结果显示, 机械通气时间长、气囊充气不足、合并低血钾、血清IL-6水平高与PAB水平低是重症肺炎无创机械通气患者发生腹胀的危险因素(OR>1, P<0.05)。结论重症肺炎无创机械通气患者发生腹胀的相关因素可能与机械通气时间长、气囊充气不足、合并低血钾、IL-6水平高及PAB水平低有关。

Objective To analyze the influencing factors of abdominal distension in patients with severe pneumonia undergoing noninvasive mechanical ventilation.Methods A total of 130 patients with severe pneumonia treated in Affiliated Hospital of Henan Medical College from October 2018 to October 2020 were selected as the research objects.The incidence of abdominal distension after noninvasive mechanical ventilation was counted and grouped.The baseline data form was designed,and possible influencing factors were incorporated to find out the risk factors for abdominal distension in patients with severe pneumonia undergoing noninvasive mechanical ventilation.Results Among 130 patients with severe pneumonia,53 cases(40.77%)had abdominal distention,and 77 cases(59.23%)didn’t have abdominal distention.The proportions of insufficient air bag inflation and hypokalemia in the occurrence group(50.94%,27/53;35.85%,19/53)were higher than those in the non occurrence group(29.87%,23/77;15.58%,12/77),P<0.05.Compared with the non occurrence group,the occurrence group had longer length of noninvasive mechanical ventilation application,higher interleukin-6(IL-6)level and lower prealbumin(PAB)level(P<0.05).Results of Logistic regression analysis showed that long length of noninvasive mechanical ventilation application,insufficient air bag inflation,hypokalemia,high serum IL-6 and low PAB level were the risk factors for abdominal distension in patients with severe pneumonia undergoing noninvasive mechanical ventilation(OR>1,P<0.05).Conclusions The related factors of abdominal distension in patients with severe pneumonia undergoing noninvasive mechanical ventilation may be related to long time length of noninvasive mechanical ventilation application,insufficient air bag inflation,hypokalemia,high level of IL-6 and low levels of PAB.