摘要
目的了解急性脑血管病机械通气患者院内死亡的预后因素。方法对大连医科大学附属第一医院中心ICU2005年1月～2007年12月间所有进行机械通气治疗并且资料完整的94例急性脑血管病内科患者的资料进行回顾性分析,依据出院结果分为死亡组和生存组,对包括年龄、性别、病史、入院时的血气分析以及APACHEⅡ评分等各项指标进行单因素及多因素Logistic回归分析。结果50例(53.2%)死亡,44例(46.8%)生存出院。单因素分析发现两组间APACHEⅡ评分、血糖、总住院时间、ICU住院时间、机械通气时间、气管切开、肺内感染、病变部位及性质有显著差异(P均<0.05)。多因素Logistic回归分析表明血糖、肺内感染、幕下病变、机械通气时间是增加院内死亡风险的独立预后危险因素(P均<0.05),而ICU住院时间为保护性因素(P<0.05)。结论需机械通气的急性脑血管病患者病死率高,治疗过程中应积极控制血糖及肺内感染等预后危险因素,并对患者的预后做出正确评估。
Objective To investigate the outcome and prognostic factors of hospital mortality in patients with acute cerebrovascular disease requiring mechanical ventilation. Methods Data from 94 patients with acute cerebrovascular disease in central intensive care unit （ICU） were collected and retrospectively analyzed. Prognostic factors of hospital mortality were analyzed by univariate statistics and multivariate logistic regression. Results Hospital mortality was 53.2% （50/94）. There was significance diference in parameters such as APACHE Ⅱ score,blood glucose ,lengh of hospital stay,lengh of ICU stay, time of mechanical ventilation, incision of trachea, lung infections, lesion loci and its nature between the survival and non-survival groups （ all P 〈 0. 05 ）. Multivariate logistic regression revealed that blood glucose,lung infections, diseased region under tentorium of cerebellum, time of mechanical ventilation were independent prognostic risk factors of hospital mortality（ all P 〈0.05 ）. Whereas the lengh of ICU stay was protective factor （P 〈 0.05）. Conclusion The hospital mortality is considerably high in patients with acute eerebrovascular disease requiring mechanical ventilation. The prognostic factors such as blood glucose and lung infections should be evaluate cautiously and prevented aggressively.
出处
《中国呼吸与危重监护杂志》
CAS
2008年第4期281-285,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
机械通气
脑血管病
院内死亡
预后因素
Mechanical ventilation
Cerebrovascular diseases
Hospital mortality
Prognostic factors
