无创呼吸机治疗COPD急性加重期老年患者发生抗生素相关腹泻的危险因素分析

Analysis on risk factors of antibiotic related diarrhea occurrence in elderly patients with acute exacerbation of COPD treated by non-invasive ventilator

目的分析无创呼吸机治疗慢性阻塞性肺疾病(COPD)急性加重期老年患者发生抗生素相关腹泻的危险因素。方法回顾性分析2020年6月至2023年6月在该院治疗的248例COPD急性加重期老年患者的临床资料,单因素及多因素logistic回归分析探讨患者发生抗生素相关腹泻的影响因素。结果248例无创呼吸机治疗COPD急性加重期老年患者中共49例(19.76%)发生抗生素相关腹泻。单因素及多因素logistic回归分析显示,年龄≥70岁、无创呼吸机治疗时间≥7 d、使用广谱抗生素、抗生素治疗时间≥7 d、住院时间≥10 d及重度病情等是无创呼吸机治疗COPD急性加重期老年患者发生抗生素相关腹泻的独立危险因素(P<0.05),而每天对无创呼吸机管路和面罩进行消毒是其独立保护因素(P<0.05)。结论无创呼吸机治疗的COPD急性加重期老年患者抗生素相关腹泻发生率较高,其与患者的年龄、通气时间、呼吸机管路和面罩消毒情况、抗生素使用时间、是否使用广谱抗生素、住院时间及病情严重程度等有关。

Objective To explore the risk factors of antibiotic related diarrhea occurrence in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)treated by non-invasive ventilator.Methods The clinical data of 248 elderly patients with acute exacerbation of COPD treated in this hospital from June 2020 to June 2023 were analyzed retrospectively.The univariate and multivariate logistic regression were used to analyze the influencing factors for the patients with antibiotic related diarrhea occurrence.Results Among 248 elderly patients with acute exacerbation of COPD,49 cases(19.76%)developed antibiotic related diarrhea.The results of univariate and multivariate logistic regression analysis showed that the age≥70 years old,non-invasive ventilator treatment time≥7 d,broad-spectrum antibiotics use,antibiotic treatment time≥7 d,hospitalization duration≥10 d and severe illness condition were the risk factors for antibiotic related diarrhea occurrence in the elderly patients with acute exacerbation of COPD(P<0.05),while the daily disinfection of ventilator tubes and masks was a protective factor(P<0.05).Conclusion The incidence rate of antibiotic-related diarrhea in the elderly patients with acute exacerbation of COPD treated by non-invasive ventilator is high,which is closely related to the age of patients,ventilation time,ventilator pipeline and mask disinfection,antibiotic use time,whether using broad-spectrum antibiotics,hospitalization duration and severity of disease condition.