高龄老年患者机械通气的撤机影响因素分析

目的]了解影响高龄老年患者机械通气撤机的危险因素.方法]将198 例高龄机械通气患者分为撤机成功组和撤机失败组,对年龄、通气前血气及急性生理学（APS）评分、通气并发症等进行回顾性分析,并对各项指标进行Logistic 回归分析.结果]80例（40.7%）患者撤机成功.单变量分析中,两组间年龄、APS评分、通气天数、切开、通气过程中呼吸机相关性肺炎（VAP）及多器官障碍综合征（MODS）的发生具有显著性差异（P〈0.05）,多因素Logistic回归显示年龄、APS评分、通气过程中VAP及MODS是影响撤机的危险因素（均P〈0.05）.结论]在评估高龄患者的撤机时,除了关注疾病的严重程度及通气并发症等相关情况,还应该考虑年龄的不利因素.

Analysis of Influential Factors About Weaning in oldest-old Patients Requiring Mechanical Ventilation

Objective]To investigate the risk factors of weaning in oldest old patients receiving mechanical ventilation. Methods] A total of 198 oldest-old patients receiving mechanical ventilation from senile ward were divided into weaning success group and weaning failure group. The clinical data of all patients were retro- spectively analyzed by logistic regression method. Results] Of the 198 patients , 80 cases （40.7 %） weaned successfully. Univariate analysis showed that there were significant differences in age, acute physiology scores （APS）, duration of ventilation, tracheotomy and occurrence of VAP and MODS between the two groups（ P 〈 0.05）. Multiple logistic regression analysis showed that age, APS, occurrence of VAP and MODS were independent risk factors of weaning. Conclusion] When the weaning of oldest-old patients is evaluated, besides the severity of disease and complications of ventilation , the adverse factor of age should be paid attention.