氧合指数与血管外肺水指数的动态变化对急性呼吸窘迫综合征患者预后的判断价值(1)
[摘要] 目的 探讨氧合指数与血管外肺水指数的动态变化对急性呼吸窘迫综合征(ARDS)患者预后的判断价值。方法 选取我院2016年1月～2017年1月期间收治的48例ARDS患者作为研究对象，将其分为治愈组与死亡组，其中治愈组37例，死亡组11例，观察氧合指数、血管外肺水指数等相关指标。 结果 死亡组APACHE Ⅱ评分高于治愈组，差异有统计学意义(P<0.05)；治愈组氧合指数不断增加，EVLWI、PVPI不断降低；死亡组患者氧合指数不断降低，CI、PVPI、EVLWI指数不断增加，第3日与首日相比较，差异有统计学意义(P<0.05)；治愈组第3日氧合指数增加，EVLWI、CI水平下降，与死亡组比较差异有统计学意义(P<0.05)；氧合指数与EVLWI为负相关。 结论 氧合指数与血管外肺水指数的动态变化对急性呼吸窘迫综合征患者预后工作开展具有显著的判断价值。
[关键词] 急性呼吸窘迫综合征；氧合指数；血管外肺水指数；预后
[中图分类号] R563.8 [文献标识码] A [文章编号] 1673-9701(2018)01-0001-03
The judgment value of dynamic changes of oxygenation index and extravascular lung water index in judging the prognosis of patients with acute respiratory distress syndrome
TAN Baoling
Department of Emergency Medicine， Xiangtan Central Hospital in Hu'nan Province， Xiangtan 411100， China
[Abstract] Objective To evaluate the judgment value of dynamic changes of oxygenation index and extravascular lung water index in judging the prognosis of patients with acute respiratory distress syndrome(ARDS). Methods 48 patients with ARDS who were treated in our hospital from January 2016 to January 2017 were selected as the subjects. The patients were divided into the cured group(n=37) and the death group(n=11). The related indicators including oxygenation index and extravascular lung water index were observed. Results The APACHE Ⅱ score in the death group was higher than that in the cured group， and the difference was significant(P<0.05). The oxygenation index of the cured group was increasing and the EVLWI and PVPI were decreasing. The oxygenation index of the death group was decreasing， and the CI， PVPI and EVLWI were increasing(P<0.05). And the differences in the indicators between the third day and the first day were significant(P<0.05). The oxygenation index was increased and the EVLWI， CI levels were decreased in the cured group on the third day， and the difference was statistically significant compared with death group(P<0.05). The oxygenation index was negatively correlated with EVLWI. Conclusion The dynamic changes of oxygenation index and extravascular lung water index have significant judgment value on the prognosis of patients with acute respiratory distress syndrome.
[Key words] Acute respiratory distress syndrome； Oxygenation index； Extravascular lung water index； Prognosis
急性呼吸窘迫綜合征(acute respiratory distress syndrom，ARDS)是由肺内外相关致病因素引发的进行性、急性缺氧呼吸衰竭，其病情较为复杂，临床治疗难度较高，预后情况比较严重，如果治疗不及时则会直接危及到生命安全，具有较高的死亡率[1，2]。目前临床中常见的病情评估方法尽管能够显示出患者病情的严重程度，但是对于预后评估的特异性不足，而脉搏指示连续心排血量(pulse indicated continuous cardiac output，PiCCO)开始在临床检测中得以应用，对患者血管外肺水指数(extravascular lung water index，EVLWI)、氧合指数及其他相关指标的动态变化进行检测，对于预后判断具有较高的应用价值[3，4]。基于上述情况，本研究对48例ARDS患者的临床资料进行回顾性分析，对氧合指数、EVLWI动态变化对ARDS预后的判断价值展开研究，现报道如下。, 百拇医药(谭宝玲)
[关键词] 急性呼吸窘迫综合征；氧合指数；血管外肺水指数；预后
[中图分类号] R563.8 [文献标识码] A [文章编号] 1673-9701(2018)01-0001-03
The judgment value of dynamic changes of oxygenation index and extravascular lung water index in judging the prognosis of patients with acute respiratory distress syndrome
TAN Baoling
Department of Emergency Medicine， Xiangtan Central Hospital in Hu'nan Province， Xiangtan 411100， China
[Abstract] Objective To evaluate the judgment value of dynamic changes of oxygenation index and extravascular lung water index in judging the prognosis of patients with acute respiratory distress syndrome(ARDS). Methods 48 patients with ARDS who were treated in our hospital from January 2016 to January 2017 were selected as the subjects. The patients were divided into the cured group(n=37) and the death group(n=11). The related indicators including oxygenation index and extravascular lung water index were observed. Results The APACHE Ⅱ score in the death group was higher than that in the cured group， and the difference was significant(P<0.05). The oxygenation index of the cured group was increasing and the EVLWI and PVPI were decreasing. The oxygenation index of the death group was decreasing， and the CI， PVPI and EVLWI were increasing(P<0.05). And the differences in the indicators between the third day and the first day were significant(P<0.05). The oxygenation index was increased and the EVLWI， CI levels were decreased in the cured group on the third day， and the difference was statistically significant compared with death group(P<0.05). The oxygenation index was negatively correlated with EVLWI. Conclusion The dynamic changes of oxygenation index and extravascular lung water index have significant judgment value on the prognosis of patients with acute respiratory distress syndrome.
[Key words] Acute respiratory distress syndrome； Oxygenation index； Extravascular lung water index； Prognosis
急性呼吸窘迫綜合征(acute respiratory distress syndrom，ARDS)是由肺内外相关致病因素引发的进行性、急性缺氧呼吸衰竭，其病情较为复杂，临床治疗难度较高，预后情况比较严重，如果治疗不及时则会直接危及到生命安全，具有较高的死亡率[1，2]。目前临床中常见的病情评估方法尽管能够显示出患者病情的严重程度，但是对于预后评估的特异性不足，而脉搏指示连续心排血量(pulse indicated continuous cardiac output，PiCCO)开始在临床检测中得以应用，对患者血管外肺水指数(extravascular lung water index，EVLWI)、氧合指数及其他相关指标的动态变化进行检测，对于预后判断具有较高的应用价值[3，4]。基于上述情况，本研究对48例ARDS患者的临床资料进行回顾性分析，对氧合指数、EVLWI动态变化对ARDS预后的判断价值展开研究，现报道如下。, 百拇医药(谭宝玲)