创伤后患者发生急性呼吸衰竭的危险因素分析及护理对策

Risk factors analysis and nursing of acute respiratory failure after trauma

目的探讨创伤后患者发生急性呼吸衰竭(acute respiratoryfailure,ARF)的危险因素分析及护理对策。方法选择杭州师范大学附属医院2014年5月—2016年5月间收治的214例患者,依据患者术后是否发生急性呼吸衰竭,将患者分为观察组(发生者,61例)和对照组(未发生,153例)。制作危险因素调查表,收集2组患者年龄、吸烟史、合并糖尿病和高血压病、合并呼吸系统疾病史、休克持续时间、创伤指数评分、APACHE评分等因素资料。采用单因素和Logistic回归分析对收集的数据资料进行分析。结果 214例创伤患者有61例发生ARF,发生率为28.5%(61/214)。单因素分析显示:年龄、合并糖尿病和高血压病、合并呼吸系统疾病史、休克持续时间、创伤指数评分、APACHE评分是创伤后患者发生ARF的单因素危险因素;Logistic回归分析结果显示:年龄、合并呼吸系统疾病史、休克持续时间、创伤指数评分、APACHE评分是创伤后患者发生ARF的独立危险因素。结论创伤后极易发生ARF,年龄、合并糖尿病和高血压病、合并呼吸系统疾病史、休克持续时间、创伤指数评分、APACHE评分是创伤后患者发生ARF的危险因素,临床中要及时判断出危险因素,做好治疗和护理。

Objective To investigate the risk factors and nursing of acute respiratory failure after trauma. Methods Two hundred and fourteen patients admitted to our hospital from May,2014 to May,2016 were selected. And according to the presence or absence of respiratory failure,the patients were divided into observation group( with acute respiratory failure,61 cases) and control group( without acute respiratory failure,153 cases). The risk factors questionnaire was made,and the age,smoking history,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score of two groups were collected. The data were analyzed by univariate and logistic regression analysis.Results In all 214 trauma patients,61 had ARF,the incidence rate was 28. 5%( 61/214). Univariate analysis showed that age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were the single factor risk factors for ARF after trauma. Logistic regression analysis showed that age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were independent factor risk factors for ARF after trauma. Conclusion Trauma patients easily had ARF,and age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were the risk factors of ARF after trauma. Risk factors in clinical should be judged,and good treatment and nursing of disease should be done.