目的 探究重症急性呼吸窘迫综合征患者气管插管后发生低血压的危险因素,为该病的治疗提供理论依据.方法 选取2014年2月~2016年2月于本院行气管插管术治疗的110例重症急性呼吸窘迫综合征患者进行研究,根据是否发生低血压将其分为低血压组和正常血压组.其中低血压组患者34例,收缩压下降至90 mmHg或下降幅度超过40 mmHg;正常血压组患者76例,收缩压在90 mmHg以上(包括90 mmHg)并且下降幅度不超过40 mmHg(包括40 mmHg).观察比较两组患者的一般资料、插管前后的基本生命体征和实验室指标,并采用单因素分析确定其危险因素,在此基础上再采用多因素logistic回归分析确定危险因素与血压下降的相关性.结果 两组患者的体重、体重指数、插管前收缩压、插管前舒张压以及插管后收缩压的比较差异有统计学意义(P0.05),插管后差异显著(P<0.05).两组患者插管前血浆白蛋白的差异有统计学意义(P<0.05).多因素回归分析结果显示,体重、体重指数、插管前收缩压、插管前舒张压以及血浆白蛋白是插管后低血压的关系密切,差异有统计学意义(P<0.05).结论 低体重、低体重指数、插管前低收缩压、插管前低舒张压以及低白蛋白水平是ARDS患者气管插管后发生低血压的危险因素.因此,急诊医师应在插管前注意危险因素,并采取相关预防措施避免插管后低血压的发生,提高患者的救治成功率.“,”Objective To explore the risk factors of hypotension after tracheal intubation in patients with severe acute respiratory distress syndrome, and to provide theoretical basis for the treatment of the disease. Methods A total of 110 patients with severe acute respiratory distress syndrome who underwent tracheal intubation in our hospital from February 2014 to February 2016 were enrolled into the study. They were divided into a hypotension group (n=34) and a normal blood pressure group (n=76) according to their blood pressure. The hypotension group presented less than 90 mmHg of or more than 40 mmHg decline in systolic blood pressure, while the normal blood pressure group presented not less than 90 mmHg of or not more than 40 mmHg decline in systolic blood pressure. They were compared for general information, vital signs before and after tracheal intubation. The risk factors were identified by single factor analysis, while multivariate logistic regression analysis was used to determine the correlation between the risk factors and blood pressure decline. Results Statistical differences were found as to weight, body mass index, systolic and diastolic blood pressures before intubation, and systolic blood pressure after intubation between the two groups (P<0.05). In addition, no significant difference was seen in APACHE II score after intubation between the two groups (P<0.05). The two groups produced remarkably different levels of plasma albumin before intubation (P<0.05). According to multifactor regression analysis, weight, body mass index, systolic and diastolic blood pressures before intubation, and plasma albumin were closely associated with hypotension after intubation (P<0.05). Conclusion Low body weight, body mass index, systolic and diastolic blood pressures before intubation and albumin level are the risk factors of hypotension after tracheal intubation in ARDS patients. Therefore, emergency physicians should pay attention to the factors before intubation, and take preventive measures to avoid the occurrence of hypotension after intubation, and improve the successful rate of treatment.