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目的分析需要机械通气的肺结核并发呼吸衰竭患者死亡相关的危险因素,为减少患者死亡提供依据。方法收集2010年1月至2012年12月在我院ICU收治的需要机械通气的肺结核并发呼吸衰竭的患者共106例,按照预后情况分为死亡组62例(58.5%)和生存组44例(41.5%),分析与患者死亡密切相关的影响因素。结果两组患者在结核多耐药率、急性生理和慢性健康(APACHE II)评分、院内获得性肺炎(HAP)、心功能不全、肝功能不全、感染性休克、多器官功能障碍综合征(MODS)、机械通气时间、肺叶受累程度差异均有统计学意义(P<0.05,P<0.01),其中多耐药、HAP、MODS、机械通气时间延长、多肺叶受累是需要机械通气的肺结核合并呼吸衰竭患者死亡的独立相关因素(P<0.05)。结论需要机械通气的肺结核合并呼吸衰竭患者病死亡率非常高,多耐药、HAP、MODS、机械通气时间延长、多肺叶受累影响其预后。
Objective To analyze the risk factors related to the death of patients with pulmonary tuberculosis complicated with respiratory failure requiring mechanical ventilation and provide basis for reducing the death of patients. Methods A total of 106 patients with pulmonary-tuberculosis complicated with respiratory failure admitted to our hospital from January 2010 to December 2012 were divided into two groups according to the prognosis: death (62.5%) and survival (44.0) 41.5%), analysis of the factors closely related to the death of patients. Results There was no significant difference in the rates of multidrug resistance, APACHE II, HAP, cardiac insufficiency, (P <0.05, P <0.01), including multidrug resistance, HAP, MODS, prolonged mechanical ventilation, multiple pulmonary involvement is required for mechanical ventilation in pulmonary tuberculosis combined with respiratory Independent related factors of death in patients with failure (P <0.05). Conclusions Patients with pulmonary tuberculosis complicated with respiratory failure requiring mechanical ventilation have very high mortality rate, multi-drug resistance, prolonged mechanical ventilation time and HAP, MODS, and prognosis.