重症肺炎合并重度急性呼吸窘迫综合征患者临床特点与预后影响因素分析
|
摘要
目的旨在观察重症肺炎合并重度急性呼吸窘迫综合征患者的临床特点以及预后的影响因素。方法方便选取该院2016年8月—2018年8月收治的92例重症肺炎合并重症急性呼吸窘迫综合征患者作为研究对象,结合患者病情以及病历资料进行综合性的回顾与分析,根据患者死亡情况,将其中出现死亡的53例作为观察组,剩下存活的患者作为对照组39例。观察重症肺炎合并重度急性呼吸窘迫综合征患者的临床特点以及预后影响。结果行病原学检查主要影响患者病毒感染以H1N1为主要病毒,占据所有感染比率的35.8%。通过对2组患者临床指征进行比较发现,观察组患者年龄(67.35±3.18)岁高于对照组患者(49.36±10.20)岁,呼吸重症监护病房住院时间(8.65±2.18)d、机械通气时间(6.77±4.16)d以及氧合指数(86.35±21.05)、明显低于对照组患者(16.35±4.20)d、(15.69±4.82)d、(109.14±21.06),差异有统计学意义(P<0.05)。患者WBC、血小板、血红蛋白、CRP、PCT以及白蛋白与其预后无明显相关性(P>0.05)。结论重症肺炎合并重度急性呼吸窘迫综合征患者死亡率较高,影响预后的相关因素与患者年龄、呼吸重症监护病房住院时长、实施机械通气时长以及氧合指数等密切相关,而与患者WBC、血小板、血红蛋白、CRP、PCT以及白蛋白水平无明显相关性。
Objective To observe the clinical features and prognostic factors of patients with severe pneumonia complicated with severe acute respiratory distress syndrome. Methods A total of 92 patients with severe pneumonitis complicated with severe acute respiratory distress syndrome admitted to our hospital from August 2016 to August 2018 were conveniently enrolled in the study. Combined with the patient's condition and medical records, a comprehensive review and analysis were conducted. According to the patient's death, 53 patients with death occurred as the observation group, and the remaining surviving patients served as the control group 39 patients. To observe the clinical features and prognosis of patients with severe pneumonia complicated with severe acute respiratory distress syndrome. Results The pathogen examination mainly affected the virus infection of patients with H1 N1 as the main virus, accounting for 35.8% of all infections. By comparing the clinical indications of the two groups of patients, the age of the observation group was(67.35±3.18) years old, which was higher than that of the control group(49.36±10.20)years old, the hospitalization time of the respiratory intensive care unit was(8.65±2.18)d, and the mechanical ventilation time was(6.77±4.16)d and oxygenation index(86.35 ±21.05), significantly lower than the control group(16.35±4.20)d,(15.69±4.82)d,(109.14±21.06), the difference was statistically significant(P<0.05). There was no significant correlation between WBC, platelet, hemoglobin, CRP, PCT and albumin in patients with prognosis(P>0.05). Conclusion The mortality of patients with severe pneumonia complicated with severe acute respiratory distress syndrome is high. The factors affecting prognosis are closely related to the age of the patient, the length of hospital stay in the respiratory intensive care unit, the duration of mechanical ventilation and the oxygenation index, and the patients with WBC and platelets. There was no significant correlation between hemoglobin, CRP, PCT, and albumin levels.
Objective To observe the clinical features and prognostic factors of patients with severe pneumonia complicated with severe acute respiratory distress syndrome. Methods A total of 92 patients with severe pneumonitis complicated with severe acute respiratory distress syndrome admitted to our hospital from August 2016 to August 2018 were conveniently enrolled in the study. Combined with the patient's condition and medical records, a comprehensive review and analysis were conducted. According to the patient's death, 53 patients with death occurred as the observation group, and the remaining surviving patients served as the control group 39 patients. To observe the clinical features and prognosis of patients with severe pneumonia complicated with severe acute respiratory distress syndrome. Results The pathogen examination mainly affected the virus infection of patients with H1 N1 as the main virus, accounting for 35.8% of all infections. By comparing the clinical indications of the two groups of patients, the age of the observation group was(67.35±3.18) years old, which was higher than that of the control group(49.36±10.20)years old, the hospitalization time of the respiratory intensive care unit was(8.65±2.18)d, and the mechanical ventilation time was(6.77±4.16)d and oxygenation index(86.35 ±21.05), significantly lower than the control group(16.35±4.20)d,(15.69±4.82)d,(109.14±21.06), the difference was statistically significant(P<0.05). There was no significant correlation between WBC, platelet, hemoglobin, CRP, PCT and albumin in patients with prognosis(P>0.05). Conclusion The mortality of patients with severe pneumonia complicated with severe acute respiratory distress syndrome is high. The factors affecting prognosis are closely related to the age of the patient, the length of hospital stay in the respiratory intensive care unit, the duration of mechanical ventilation and the oxygenation index, and the patients with WBC and platelets. There was no significant correlation between hemoglobin, CRP, PCT, and albumin levels.
引文
[1]孙莉.重症肺炎并发急性呼吸窘迫征的特征及预后影响因素[J].检验医学,2016(11b):97-98.
[2]刘颖,兰青,王迪芬,等.压力控制肺复张法联合俯卧位通气救治重度急性呼吸窘迫综合征患者经验[J].中华危重病急救医学,2017,29(2):177-178.
[3]贺岚.血必净注射液联合大剂量氨溴索治疗重症肺炎合并急性呼吸窘迫综合征的疗效及对血浆TXB2、ET-1、IL-8表达的影响[J].现代中西医结合杂志,2016,25(36):4023-4025.
[4]秦蘅,王导新.中青年和老年中、重度急性呼吸窘迫综合征患者的预后相关危险因素分析[J].现代医药卫生,2017,33(14):2087-2090.
[5]刘红霞,练雯,石玥,等.预见性护理在重症肺炎相关急性呼吸窘迫综合征中的应用[J].临床医学工程,2017,24(8):1151-1152.
[6]王娟.综合性护理干预在重症肺炎急性呼吸窘迫综合征机械通气治疗中的应用[J].河南医学研究,2017,26(15):2847-2848.
[7]程燕雯,杜辛歌,王迎难,等.沙丁胺醇联合布地奈德对重症肺炎合并呼吸窘迫综合征患者心功能及血气分析的影响[J].疑难病杂志,2016,15(4):362-365.
[8]付会文.重症肺炎合并急性呼吸窘迫综合征的临床特点危险因素分析[J].临床肺科杂志,2016,21(10):1915-1917.
[2]刘颖,兰青,王迪芬,等.压力控制肺复张法联合俯卧位通气救治重度急性呼吸窘迫综合征患者经验[J].中华危重病急救医学,2017,29(2):177-178.
[3]贺岚.血必净注射液联合大剂量氨溴索治疗重症肺炎合并急性呼吸窘迫综合征的疗效及对血浆TXB2、ET-1、IL-8表达的影响[J].现代中西医结合杂志,2016,25(36):4023-4025.
[4]秦蘅,王导新.中青年和老年中、重度急性呼吸窘迫综合征患者的预后相关危险因素分析[J].现代医药卫生,2017,33(14):2087-2090.
[5]刘红霞,练雯,石玥,等.预见性护理在重症肺炎相关急性呼吸窘迫综合征中的应用[J].临床医学工程,2017,24(8):1151-1152.
[6]王娟.综合性护理干预在重症肺炎急性呼吸窘迫综合征机械通气治疗中的应用[J].河南医学研究,2017,26(15):2847-2848.
[7]程燕雯,杜辛歌,王迎难,等.沙丁胺醇联合布地奈德对重症肺炎合并呼吸窘迫综合征患者心功能及血气分析的影响[J].疑难病杂志,2016,15(4):362-365.
[8]付会文.重症肺炎合并急性呼吸窘迫综合征的临床特点危险因素分析[J].临床肺科杂志,2016,21(10):1915-1917.