标题：氧合指数等相关指标及血管外肺水指数对急性呼吸窘迫综合征患者预后的判断价值

      作者：陈智峰，贵春梅    (常德市第一人民医院重症医学科，湖南 常德 415000)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨氧合指数等相关指标及血管外肺水指数对急性呼吸窘迫综合征(ARDS)患者预后的判断价值。方法 对2016年1月至2017年4月间常德市第一人民医院 ICU收治的68例ARDS患者的临床资料进行回顾性分析，依据预后将其分为存活组50例和死亡组18例，对其入住 ICU之后的氧合指数等相关指标及血管外肺水指数的变化进行对比分析。结果 死亡组患者的APACHEⅡ评分为(33.29±8.53)分，明显高于存活组的(20.17±6.81)分，差异有统计学意义(P<0.05)；存活组患者第2天及第3天的血管外肺水指数及CI指标水平较第1天呈下降趋势，且明显低于同时间段死亡组水平，差异均有统计学意义(P<0.05)；而存活组患者氧合指数指标在第2天及第3天时较第1天呈上升趋势，且明显高于同时间段死亡组水平，差异均有统计学意义(P<0.05)；血管外肺水指数与氧合指数之间呈负相关性(r=-0.91，P=0.001)，而与CVP之间无相关性(r=-0.06，P>0.05)。结论 对氧合指数等相关指标及血管外肺水指数进行动态监测，在一定程度上有利于对急性呼吸窘迫综合征患者的预后及病情进行判定，具有重要的临床价值。
      【关键词】 急性呼吸窘迫综合征；氧合指数；血管外肺水指数；预后价值
      【中图分类号】 R442.8 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2380—03

Value of oxygenation index and other related indicators and extravascular lung water index in predicting theprognosis of patients with acute respiratory distress syndrome.
CHEN Zhi-feng, GUI Chun-mei. Department ofIntensive Care, the First People's Hospital of Changde City, Changde 415000, Hunan, CHINA
【Abstract】 Objective To investigate the value of oxygenation index and related indexes and extravascular lungwater index in predicting the prognosis of patients with acute respiratory distress syndrome (ARDS). Methods The clini-cal data of 68 patients with ARDS were retrospectively analyzed, who were admitted to the First People's Hospital ofChangde City from January 2016 to April 2017 were divided into survival group (n=50) and death group (n=18) accord-ing to their prognosis. Comparative analysis was conducted on changes of oxygenation index and other indicators and ex-travascular lung water index after their admission to ICU. Results The APACHE Ⅱ score of the patients in the deathgroup was (33.29±8.53), significantly higher than (20.17±6.81) in the survival group (P<0.05). The level of the extravas-cular lung water index and CI index on the 2nd and 3rd day of the survival group showed a downward trend compared withthe first day, and were significantly lower than the level of the death group at the same time (P<0.05); while the oxygen-ation index of the surviving group showed an upward trend on the 2nd and 3rd day than on the 1st day, and were significant-ly higher than the level of the death group at the same time; all differences were statistically significant (P<0.05). Extra-vascular lung water index was negatively correlated with oxygenation index (r=-0.91, P=0.001), but had no correlationwith CVP (r=-0.06, P>0.05). Conclusion Dynamic monitoring of oxygenation index and other related indicators andextravascular lung water index is helpful to determine the prognosis and condition of patients with acute respiratory dis-tress syndrome to a certain extent, which has important clinical value.
      【Key words】 Acute respiratory distress syndrome; Oxygenation index; Extravascular lung water index; Prognos-tic value·论 著·doi:10.3969/j.issn.1003-6350.2018.17.004基金项目：湖南省卫生计生委科研计划课题医疗科研公益项目(编号：B2017189)