综合重症监护病房患者胸腔积液的临床分析

目的研究综合重症监护病房(ICU)患者胸腔积液的临床特点。方法选择2005-01～2006-06入住ICU的患者632例,依据住ICU期间有无胸腔积液分为胸腔积液组和非胸腔积液组。分析原因并比较两组患者呼吸衰竭的发生率、机械通气时间及预后。结果632例患者胸腔积液的发生率是58%,基础疾病以创伤、病理产科、急性胰腺炎和外科手术后为主,发生胸腔积液的相关因素以低蛋白血症及多脏器功能障碍综合征最常见。胸腔积液组呼吸衰竭的发生率高于非胸腔积液组(P<0.01),机械通气时间长于非胸腔积液组(P<0.05);胸腔积液组的死亡率明显高于非胸腔积液组(P<0.05)。结论综合ICU患者胸腔积液的发生率高,合并胸腔积液较无胸腔积液的患者在呼吸衰竭的发生率、机械通气平均时间方面差异均有统计学意义,且与预后相关;ICU患者发生胸腔积液的原因明显区别于普通病房。

Clinical analysis of the patients with pleural effusion in intensive care unit

Objective To investigate the clinical characteristics of the patients with pleural effusion in intensive care unit(ICU).Methods 632 patients were selected and retrospectively analyzed in the study from January 2005 to June 2006.All the patients were divided into two groups according to having pleural effusion or not in the time of ICU stay:pleural effusion group and non-pleural effusion group.The rate of respiratory failure,the time of mechanical ventilation and prognosis were compared between the two groups and the results were analysed with statistical methods.Results The incidence rate of pleural effusion was 58% in the 632 patients.The primary diseases were mainly trauma,pathologic obstetrics acute pancreatitis and after surgical operations.The correlation factors of the pleural effusion were hypoproteinemia and MODS,and the percentage were 57% and 48% respectively.Pleural effusion group had higher respiratory failure rate(P<0.01),mechanical ventilation time(P<0.05) and mortality(P<0.05).Conclusion The patients in ICU have high incidence rate of pleural effusion.There were significant differences in respiratory failure rate,mechanical ventilation time and mortality between the patients in two groups,and which correlated with the prognosis.The reasons of patients with pleural effusion in ICU were obviously distinguished from those of patients in general wards.