危重症患者气管插管后低血压发生情况及其影响因素分析

Incidence and influencing factors of hypotension in critically ill patients after tracheal intubation

目的分析急诊危重症患者紧急气管插管后低血压的发生情况及其危险因素。方法回顾性收集行气管插管的危重症患者病历资料,依据插管后血压情况分组,分析患者发生低血压的危险因素,并采用受试者工作特征(ROC)曲线分析模型预测价值。结果共收集102例患者,其中31例(30.39%)在气管插管后出现低血压(低血压组),71例(69.61%)血压正常(血压正常组);2组体质量、体重指数、收缩压、舒张压、血浆白蛋白水平比较,差异有统计学意义(均P<0.05)。Logistic回归分析结果显示,体质量、体重指数、插管前收缩压、插管前舒张压、血浆白蛋白为急诊危重症患者气管插管后低血压的危险因素,各变量预测急诊危重症患者气管插管后低血压的AUC值分别为0.762、0.739、0.717、0.758、0.834(均P<0.05)。结论急诊危重症患者紧急气管插管后低血压发生率较高,临床可通过患者的体重指数、插管前收缩压和舒张压、血浆白蛋白进行预估。

Objective To analyze the incidence and risk factors of hypotension in critically ill patients after emergency tracheal intubation.Methods A retrospective collection of medical records from critically ill patients who underwent endotracheal intubation was conducted.Patients were grouped based on their blood pressure status after intubation.The risk factors associated with hypotension were analyzed,and the predictive value of the model was assessed using the receiver operating characteristic(ROC)curve analysis.Results A total of one hundred and two patients were included in the study,among which 31 cases(30.39%)experienced hypotension following tracheal intubation(hypotension group),while 71 cases(69.61%)maintained normal blood pressure(normal blood pressure group).There were statistically significant differences in body mass index,weight,systolic blood pressure,diastolic blood pressure,and plasma albumin levels between the two groups(all P<0.05).The results of the Logistic regression analysis revealed that body mass index,weight,pre-intubation systolic blood pressure,pre-intubation diastolic blood pressure,and plasma albumin were risk factors for hypotension in critically ill patients following emergency tracheal intubation.The AUC values for each variable in predicting post-intubation hypotension in emergency critically ill patients were 0.762,0.739,0.717,0.758,and 0.834,respectively(all P<0.05).Conclusions The incidence of hypotension following emergency tracheal intubation is relatively high in critically ill patients.Clinically,the occurrence of hypotension can be estimated through the patient's body mass index,pre-intubation systolic and diastolic blood pressure,and plasma albumin levels.