康复医学科气管切开重症患者影响拔管的多因素分析

关键词：重症  康复  气管切开  危险因素

Keywords:severe  rehabilitation  tracheotomy  risk factors

摘要：

      摘要 目的：分析康复医学科气管切开的重症患者早期康复，在22天平均住院日内拔管困难的临床特点及影响拔管的因素，为提高气管切开拔管率提供理论依据。 方法：收集2018年9月—2020年5月新疆医科大学第一附属医院康复医学科，在22天平均住院日内住院的气管切开患者临床资料，按已拔管、未拔管分组，采用SPSS17.0软件进行影响拔管的单因素分析及多因素Logistic回归分析。 结果：①影响拔管的单因素分析：两组间在年龄、脑卒中、脑外伤、吞咽功能障碍、癫痫、意识障碍差异有显著性意义（均P＜0.05），两组间在性别、脊髓损伤、吉兰巴雷综合征、颅内肿瘤、其他疾病、认知功能障碍、心理障碍、肺部感染、呼吸衰竭、肺栓塞、气道结构异常差异无显著性意义（均P＞0.05）。②影响拔管的多因素Logistic回归分析：年龄、癫痫、吞咽功能障碍为未拔管的危险因素。 结论：康复医学科在22天的平均住院日内气管切开的早期康复重症患者中年龄、癫痫、吞咽功能障碍为未拔管的危险因素。

Abstract:

      Abstract Objective：To analyze the clinical characteristics and influencing factors of extubation difficulty in the early recovery of severe patients with tracheotomy in rehabilitation medicine department， and to provide theoretical basis for improving the extubation rate of tracheotomy. Method：The present study collected the clinical data of tracheotomy patients hospitalized in the first affiliated hospital of Xinjiang medical university from september 2018 to may 2020. According to the extubation and unextubation， the single factor analysis and multi factor logistic regression analysis were carried out by SPSS17.0 software. Result：①Univariate analysis of extubation： there were significant differences in age， stroke， brain trauma， dysphagia， epilepsy， disturbance of consciousness(P<0.05)，while no differences in sex， spinal cord injury， gilambare syndrome， intracranial tumors， other diseases， cognitive dysfunction， mental disorders， pulmonary infection，respiratory failure，pulmonary embolism， abnormal airway structure(P>0.05) between the two groups.②Multiple factors logistic regression analysis on extubation： age， epilepsy， dysphagia as risk factors for extubation. Conclusion：Age， epilepsy and dysphagia were the risk factors of extubation in the early rehabilitation patients with tracheotomy in the rehabilitation medicine department during the average hospitalization day of 22 days.