慢阻肺急性加重期伴呼吸衰竭患者序贯通气治疗失败的影响因素研究

Study on influencing factors of sequential through qi therapy failure in patients with acute exacerbation of COPD with respiratory failure

目的:探讨慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)伴呼吸衰竭(Respiratory failure,RF)患者序贯通气治疗失败的状况。方法:收集2020年5月至2021年5月新野县中医院收治的90例接受序贯通气的AECOPD伴RF患者临床资料。根据治疗结果分为失败组、成功组,比较两组患者基线资料,分析AECOPD伴RF患者序贯通气治疗失败的因素。结果:90例AECOPD伴RF经序贯通气治疗,失败19例(31.67%),成功71例(78.89%);失败组拔管时白蛋白水平低于成功组,吸烟史占比高于成功组(P<0.05);建立多元Logistic回归模型,结果显示,有吸烟史是AECOPD伴RF患者序贯通气失败的危险因素(OR>1,P<0.05);拔管时白蛋白水平高是AECOPD伴RF患者序贯通气失败的保护因素(OR<1,P<0.05)。结论:有吸烟史是AECOPD伴RF患者序贯通气失败的危险因素,拔管时白蛋白水平是AECOPD伴RF患者序贯通气失败的保护因素。

Objective To explore Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)exacerbation of chronic obstructive pulmonary disease(AECOPD)exacerbation of chronic obstructive pulmonary disease(AECOPD)exacerbation with Respiratory failure(Respiratory failure,RF)patients with sequential gas therapy failure.Methods Clinical data of 90 patients with AECOPD and RF who received sequentially penetrating gas were collected from May 2020 to May 2021 in Xinye Hospital of Traditional Chinese Medicine.According to the treatment results,the patients were divided into failure group and success group.The baseline data of the two groups were compared,and the factors of failure of sequential gas therapy in AECOPD patients with RF were analyzed.Results In 90 cases of AECOPD combined with RF through gas therapy,19 cases(31.67%)failed and 71 cases(78.89%)succeeded.The albumin level in the failed group was lower than that in the successful group,and the smoking history was higher than that in the successful group(P<0.05).Multiple Logistic regression model was established,and the results showed that smoking history was a risk factor for sequential gas failure in AECOPD patients with RF(OR>1,P<0.05).High albumin level during extubation was a protective factor for sequential gas failure in patients with AECOPD and RF(OR<1,P<0.05).Conclusion Smoking history is a risk factor for sequential gas failure in patients with AECOPD and RF,and albumin level at extubation is a protective factor for sequential gas failure in patients with AECOPD and RF.