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目的:分析慢性支气管炎住院患者进行辅助机械通气的危险因素。方法:采取回顾性统计分析方法,收集2009-2014年5年中共1746例慢性支气管炎住院患者的临床资料,应用SPSS 17软件分组对年龄、性别、肺气肿、慢性肺源性心脏病、肺性脑病、肺大泡、肺炎、支气管扩张、哮喘、冠心病、高血压病、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常等因素进行卡方检验及危险因素分析。结果:1746慢性支气管炎患者中,进行辅助机械通气治疗者626人(无创辅助通气613人、有创辅助通气187人),未进行辅助机械通气治疗者1120人。辅助机械通气治疗者中有439人单纯行无创辅助通气、13人单纯行有创辅助通气、174人为两种通气方式序贯。统计分析显示:高龄(>65岁)、慢性肺气肿、慢性肺源性心脏病、肺性脑病、糖尿病、低蛋白血症、肝功能异常、肾功能异常是慢性支气管炎患者行无创辅助通气的危险因素(OR>1,P<0.05);高龄(>65岁)、男性、慢性肺源性心脏病、肺性脑病、肺炎、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常是慢性支气管炎患者行有创辅助通气的危险因素(OR>1,P<0.05)。结论:高龄、性别以及一些肺内外合并疾病是慢性支气管炎住院患者行辅助通气的危险因素,提示在临床工作中对这一类患者加强教育、积极控制合并症具有重要的意义。
Objective: To analyze the risk factors of assisted mechanical ventilation in hospitalized patients with chronic bronchitis. Methods: A retrospective statistical analysis was conducted to collect the clinical data of 1746 hospitalized patients with chronic bronchitis in the five years from 2009 to 2014. SPSS 17 software was used to analyze the age, gender, emphysema, chronic cor pulmonale, pulmonary Encephalopathy, bullae, pneumonia, bronchiectasis, asthma, coronary heart disease, hypertension, diabetes mellitus, hypoproteinemia, anemia, liver dysfunction, renal dysfunction and other factors for chi-square test and risk factor analysis. Results: Of the 1746 patients with chronic bronchitis, 626 were assisted mechanical ventilation (613 without invasive ventilation and 187 with invasive ventilation) and 1120 without mechanical ventilation. There were 439 simple noninvasive assisted ventilation among assisted mechanical ventilation and thirteen patients with simple assisted ventilation, while 174 were sequential with two ventilation methods. Statistical analysis showed that elderly patients (> 65 years old), chronic emphysema, chronic cor pulmonale, pulmonary encephalopathy, diabetes, hypoproteinemia, abnormal liver function and renal dysfunction were patients with chronic bronchitis who underwent noninvasive assisted ventilation (OR> 1, P <0.05); elderly (> 65 years), male, chronic cor pulmonale, pulmonary encephalopathy, pneumonia, diabetes, hypoproteinemia, anemia, abnormal liver function, renal function Abnormalities were risk factors for invasive assisted ventilation in patients with chronic bronchitis (OR> 1, P <0.05). Conclusion: Age, sex and some pulmonary diseases are the risk factors for assisted ventilation in hospitalized patients with chronic bronchitis, suggesting that it is of great significance to strengthen education and control comorbidities in this kind of patients in clinical work.