小儿机械通气导致上消化道出血的危险因素分析

目的：探讨小儿机械通气导致上消化道出血的危险因素。方法：选择2008年1月-2008年12月入住我院儿科需进行机械通气48h以上的患儿进行前瞻性研究,建立相关的纳入和排除标准。入院后收集相关临床资料和危险因素指标,直至出现上消化道出血和达到终止观察标准,将各个危险因素进行统计学分析。结果：在这达到纳入标准的110例患儿中,57例出现了UGI（51．8％）。出现UGI的患儿中,60％的是在机械通气开始的24h内发生的,随着通气时间的延长,UGI的发生率逐渐下降。各危险因素中器官功能不全、APTT延长,血小板计数〈1×10^5／mm3,儿科死亡评分≥10和PIP≥25cmH2O在UGI患儿与非UGI患儿中比较具有统计学意义。结论：器官功能不全、APTT延长,血小板计数〈1×1065／mm3,儿科死亡评分≥10这些因素在机械性通气患儿UGI发生中可能具有重要的意义。PIP≥25cmH2O作为通气设定中唯一有意义的危险因素,这可能是与PIP过高会导致心输出量下降,内脏器官灌注不足有关。

The young child machinery ventilation causes the upper gastrointestinal hemorrhage the hazard factor analysis

Objective： Discusses the young child machinery ventilation to cause the upper gastrointestinal hemorrhage the hazard factor. Methods：Chooses in January, 2008 -- December, 2008 to move in my courtyard department of pediatrics to carry on the ma- chinery to ventilate the 48h above baby to conduct the forward--looking research, establishes related integration with the elimina- tion standard. After in hospital, collects the related clinical material and the hazard factor target, until has the upper gastrointesti- nal hemorrhage and achieves the termination observation standard, carries on statistics analysis each hazard faclior. Results： In this a- chieves in 110 example babies who integrates the standard, 57 examples presented UGI （51.8%）. Presents UGI in baby, what 60% is in the machinery ventilation starts in 24h occurs, along with the ventilation timCs extension, the UGI formation rate drops gradually. In various hazard factor the organ function not entire, APTT lengthens, the platelet count ~1 X 105/ram3, department of pediatrics death grading ~10 and PIP~25cmH20 the comparison has statistics significance in the UGI baby with the non--UGI baby. Conclusion：The organ function not entire, APTT lengthens, platelet count ~ 1 X 105/ram3 , department of pediatrics death grading ~10 these factors, in meehanicalness ventilates baby UGI to occur possibly has the vital significance. PIP~25cmH20 as ventilation hypothesis in only meaningful hazard factor, this will possibly he high will have caused the cardiac output with PIP to drop, the visceral organ irrigation will concern insufficient.