210例老年呼吸衰竭继发MODS的危险因素分析

Analysis of Risk Factors of 210 Elderly Patients With Respiratory Failure Secondary to Multiple Organ Dysfunction Syndrome

目的分析210例老年呼吸衰竭患者继发多器官衰竭综合征(multiple organ dysfunction syndrome,MODS)的危险因素。方法对2019年6月至2020年6月期间就诊于河南省直第三人民医院的210例老年呼吸衰竭继发MODS患者资料进行回顾性分析,并将其设定为试验组,同时将210例发生老年呼吸衰竭但未继发MODS的患者作为对照组,分析发生老年呼吸衰竭继发MODS的危险因素。结果在210例老年呼吸衰竭继发MODS患者中,发生心脏衰竭合并肾衰竭112例(53.33%),肝衰竭合并肾衰竭45例(21.42%),消化系统衰竭合并肝衰竭25例(11.90%),脑衰竭合并肝衰竭20例(9.50%),胰脏衰竭合并肝衰竭1例(0.47%),脑衰竭合并中枢神经衰竭7例(3.33%)。年龄>80岁、合并高血压、合并糖尿病、合并高血脂、合并慢性肝炎、二氧化碳潴留、肺间质纤维化、吸烟指数>400支/年、营养不良、有创机械通气、APACHEⅡ>15分、呼吸性酸中毒以及代谢性酸中毒是导致老年呼吸衰竭继发MODS的独立危险因素,而应用利尿剂则是保护因素。结论影响老年呼吸衰竭继发MODS的危险因素较多,临床应针对危险因素予以控制以降低MODS的发生率,改善预后。

Objective To analyze risk factors of multiple organ dysfunction syndrome(MODS)secondary to respiratory failure in 210 elderly patients.Methods 210 elderly patients with MODS secondary to respiratory failure who visited The Third People’s Hospital of He’nan Province between June 2019 and June 2020 were retrospectively reviewed and set as the experimental group,at the same time,210 elderly patients with respiratory failure but without secondary MODS were selected as the control group,tended to analyze the risk factors of MODS secondary to respiratory failure in the elderly.Results Among 210 patients with MODS secondary respiratory failure,112 cases were complicated with heart and renal failure(53.33%),45 cases were complicated with liver and renal failure(21.42%),25 cases of patients with digestive function failure complicated with liver failure(11.90%),20 cases with brain failure complicated with liver failure(9.5%),1 patient with pancreatic failure complicated with liver failure(0.47%),7 cases with cerebral failure combined with central nervous failure(3.33%).Aged older than 80,complicated with hypertension,diabetes mellitus hyperlipidemia,chronic hepatitis,carbon dioxide retention,pulmonary fibrosis,smoking index>400/yr,malnutrition,invasive mechanical ventilation,APACHEⅡ>15,respiratory acidosis,and metabolic acidosis were independent risk factors for secondary MODS caused by elderly respiratory failure,meanwhile the application of diuretics was the protective factor.Conclusions There are many risk factors influencing secondary MODS caused by respiratory failure in elderly patients.Risk factors should be controlled to reduce the incidence rate of MODS and improve prognosis.