| 摘要: |
| 目的 探索应用机械通气治疗的老年重症肺炎患者预后的影响因素。方法 回顾性分析2012年2月至2013年2月在国内14家三级甲等医院重症医学科收治确诊为重症肺炎且接受机械通气的老年患者165例，根据28d生存情况，分为存活组（78例）和死亡组（87例），男118例，女47例，平均年龄（79.48±7.75）岁。将两组临床资料进行比较，对可能影响预后的因素作单因素统计分析，再将有意义的单因素进一步行多因素回归分析。结果单因素分析显示，28d生存情况与APACHEⅡ评分、心率、空腹血糖、降钙素原（PCT）、血肌酐（Cr）显著正相关（P＜0.05），与血钠、尿量、氧合指数显著负相关（P＜0.01），多因素回归分析显示PCT、血钠、Cr、尿量4个因素是预后的独立危险因素（P＜0.01）。结论PCT、血钠、Cr及尿量是影响老年重症肺炎机械通气患者预后的重要指标。 |
| 关键词: 重症肺炎 机械通气 预后 |
| DOI： |
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| 基金项目:卫生行业科研专项资助项目；浙江省重点科技创新团队自主设计项目 |
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| Prognostic factors of elderly patients with severe pneumonia and treated by mechanical ventilation |
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GAO Xiang,YAN Jing,CAI Guolong,YAN Molei,LV Xiaochun,AI Yuhang,KANG Yan
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Wenzhou Medical University
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| Abstract: |
| Objective To analyze the prognostic factors of elderly patients with severe pneumonia and treated by me- chanical ventilation. Methods Clinical data of 165 elderly patients with severe pneumonia and treated by mechanical ventilation admitted in ICUs of 14 third-grade class-A hospitals between February 2012 and February 2013 were retrospectively analyzed. Among them 118 were males (71.52%) and 57 were females (28.48%) with an average age of 79.48±7.75y. The data were ana- lyzed by single factor 字2 test or t test, the statistic significantly factors were selected and used for multiple regression analysis. Results Among 165 cases, 87 survived (survival group) and 78 died (non-survival group) in 28d. The univariate analysis showed that survival in 28d was positively correlated with Acute Physiology and Chronic Health Evaluation (APECHE) scores，heart rate, fasting blood-glucose, procalcitonin(PCT) and serum creatinine(Cr)(P＜0.05), while was negatively correlated with serum sodium level，urine volume and oxygenation index (P＜0.01). Multiple regression analysis showed that PCT, serum sodium level, Cr and urine volume were the independent risk factors of prognosis (P＜0.01). Conclusion PCT, serum sodium level, Cr and urine vol- ume are the important indicators influencing the prognosis of elderly patients with severe pneumonia and treated by mechanical
ventilation. |
| Key words: Severe pneumonia Mechanical ventilation Prognosis |
