Clinical Analysis Of Related Influencing Factors Of AECOPD Patients With Difficulty Weaning

Objective:A retrospective analysis was performed to provide a theoretical basis on rational use of ventilator and improving the level of application of mechanical ventilation and rescue success rate in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) by analyzing influencing factors for weaning difficultly patients with AECOPD. Methods:The clinical data of 104 patients treated by mechanical ventilation with acute exacerbation of chronic obstructive pulmonary disease from January 2011 to November 2015 in the Department of Intensive Care Unit, The First Affiliate Hospital of Shan Xi Medical University, were selected for the study. According to the difficulty and the length of the weaning process, we classified the patients into three groups, which concluded simple weaning group, prolonged weaning group, and difficult weaning group. Then we studied the clinical data of three groups by statistical methods to analyze the influencing factors for weaning difficultly patients with AECOPD. Results:Univariate analysis showed that serum albumin, acute physiology and chronic h ealth evaluationⅡscoring(APACHEⅡ),N-terminal pro-B-type natriuretic peptides(NTproBNP), lactic acid, serum glutamic oxaloacetic transaminase(AST), serum creatinin e(SCR), duration of mechanical ventilation, the control of pulmonary infection and the ability of cough and sputum have an impact on the weaning progress. Logistic regression analysis showed that APACHEⅡscoring, NT-proBNP, the ability of coug h and sputum and duration of mechanical ventilation were the independent risk fact ors for patients with AECOPD. Conclusion:APACHEⅡscoring, NT-proBNP, the ability of cough and sputum and duration of mechanical ventilation have important consequences for patients with AECOPD when weaning from mechanical ventilation, and they were the independent risk factors for patients with AECOPD. Therefore, on the basis of the treatment of primary disease, we should take all effective measures to actively control the infection, improve the heart function and nutritional status, and gradually strengthen the ability of cough and sputum to create conditions for weaning from mechanical ventilation as early as possible for patients with AECOPD.