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目的研究重症患者实施气管插管后低血压的危险因素及患者预后情况,为重症临床工作提供理论依据。方法收集我院重症医学科2年来有关气管插管患者的临床资料进行分析,分为插管后低血压组和插管后血压正常组,采用单因素分析,得出导致插管患者出现血压下降的危险因素,在单因素分析的基础上,进行多因素Logistic回归分析确定血压下降与危险因素的相关性。预后主要指标为28天死亡率,次要预后指标为ICU住院天数和总的住院天数。结果 106例患者纳入分析,其中32例气管插管后发生低血压,单因素分析后有5个因素被认为是有意义的,包括插管前收缩压、插管前舒张压、体重、体重指数、呼吸系统疾病等,对单因素分析结果进行Logistic回归分析,插管前收缩压、插管前舒张压、体重为患者气管插管后发生低血压的独立危险因素。低血压组28天死亡率较血压正常组明显增高(34.37%比12.16%,P=0.03),ICU住院天数和总住院天数无明显差异。结论重症患者气管插管后发生低血压多见于低体重且合并低血压患者,插管后发生低血压会增加患者28天死亡率。
Objective To study the risk factors of hypotension after tracheal intubation and the prognosis of patients after severe tracheal intubation in critically ill patients so as to provide a theoretical basis for severe clinical work. Methods The clinical data of patients with endotracheal intubation collected in the Department of Critical Care Medicine of our hospital for 2 years were analyzed and divided into post-intubation hypotension group and post-intubation normotensive group. Univariate analysis showed that blood pressure decreased Based on the univariate analysis, multivariate Logistic regression analysis was performed to determine the association between the decline in blood pressure and risk factors. The main prognostic indicator was 28-day mortality, and the secondary prognostic indicators were ICU stay days and total stay days. Results Sixty-six patients were included in the analysis. Hypotension occurred in 32 patients after tracheal intubation. Five factors were considered significant after univariate analysis including systolic blood pressure before intubation, diastolic blood pressure before intubation, body weight, body mass index , Respiratory diseases, etc. The results of univariate analysis of Logistic regression analysis, before intubation systolic blood pressure, diastolic blood pressure before intubation, weight of patients with tracheal intubation hypotension after an independent risk factor. The 28-day mortality rate in hypotension group was significantly higher than that in normal blood pressure group (34.37% vs 12.16%, P = 0.03). There was no significant difference in the days of hospitalization and total hospitalization in ICU. Conclusion Severe patients with hypotension after tracheal intubation more common in patients with low body weight and low blood pressure, hypotension after intubation will increase the 28-day mortality in patients.