重症监护病房中急性呼吸窘迫综合征的预后危险因素探讨

目的 探讨重症监护病房(ICU)中急性呼吸窘迫综合征(ARDS)的死亡率以及预后危险因素.方法 根据从2009年1月～2011年1月入住某院重症监护病房(ICU)中的急性呼吸窘迫综合征(ARDS)的230例患者,采用1992年欧美ARDS联席会议提议通过的ARDS诊断标准,对患者进行持续24h的治疗时间,并进行临床观察.结果 2009年1月～2011年1月入住的重症监护病房(ICU)中的急性呼吸窘迫综合征(ARDS)的230例患者,其中肺源性患者85例,肺外源性患者145例.在此治疗期间,采用APACHEII评分标准对死亡率进行调整,调整2年时间内死亡率没有明显变化(P=0.85),并且根据多方面因素的资料研究分析,ARDS死亡因素有很多,包括患者年龄、基础病理、多功能器官功能障碍妨碍住院时间的治疗,其中导致死亡率最高的因素就是脓毒性休克和心功能衰竭,死于呼吸衰竭的患者其实很少.结论 急性呼吸窘迫综合征(ARDS)是近两年来该院接收最常见的患者之一,也是死亡率比较高的急重病,脓毒性休克和心功能衰竭都是导致ARDS死亡率增高的主要原因.

Discussion on prognostic risk factors of acute respiratory distress syndrome(ARDS) in ICU

OBJECTIVE To inquire into mortality rate and prognostic risk factors of acute respiratory distress syndrome(ARDS) in ICU.METHODS According to data of 230 sufferers with ARDS in ICU from January 2009 to January 2011,adopted ARDS criteria from Euro-American ARDS joint meeting in 1992,observed the treatment time in 24 hours.RESULTS Among 230 sufferers with ARDS in ICU from January 2009 to January 2011,85 cases of pulmonary,145 cases of exogenous pulmonary.In treatment,adopted APACHEII standard to adjust the death rate.Adjusted death rate in 2 years was not changed(P = 0.85).According to the data,there were a lot of death factors of ARDS including patients’ age,foundational pathology,hospitalization time hindered by multi-function organ dysfunction,in which septic shock and heart failure caused highest mortality,less patients died of respiratory failure.CONCLUSION ARDS is the most common cause in enrolled patients and it is an acute serious disease with higher mortality.Septic shock and heart failure are the main causes in increased mortality of ARDS.