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        west china medical publishers
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        find Author "奚晶晶" 2 results
        • 前白蛋白、D-二聚體及血小板動態變化評估重癥膿毒癥患者病情嚴重度的臨床分析

          目的 研究前白蛋白( PA) 、D-二聚體( DD) 及Plt 動態變化與重癥膿毒癥患者病情嚴重度及預后的關系。方法 測定198 例重癥膿毒癥患者入組第1 d、第5 d, 以及出院或死亡前最后一次的PA、DD、Plt、APACHEⅡ 評分, 按預后將患者分為死亡組及存活組, 進行動態觀察, 并做APACHEⅡ評分和PA、DD 及PLT 水平動態變化的相關性分析。結果 死亡組與存活組入組第1 dPA、DD 及Plt 比較均無顯著差異, 死亡組第5 d 及最后一次DD 水平明顯高于存活組( P lt;0. 05) , PA和Plt 明顯低于存活組( P lt;0. 01) 。DD 與APACHEⅡ評分呈正相關, PA、Plt 與APACHEⅡ評分呈負相關。結論 DD與膿毒癥患者病情嚴重程度呈正相關, PA 與病情嚴重程度呈負相關。DD 持續高水平與PA、Plt 持續低水平提示病情危重, 預后不良, 所以聯合動態觀察PA、DD 和Plt 對判斷病情危重度及預后有一定的評估價值。

          Release date:2016-09-14 11:23 Export PDF Favorites Scan
        • Risk Factors for Lower Airway Bacteria Colonization and Ventilator-Associated Pneumonia in Mechanically Ventilated Patients

          Objective To analysis the risk factors for lower airway bacteria colonization and ventilator-associated pneumonia ( VAP) in mechanically ventilated patients. Methods A prospective observational cohort study was conducted in intensive care unit. 78 adult inpatients who underwent mechanical ventilation( MV) through oral endotracheal intubation between June 2007 and May 2010 were recruited. Samples were obtained from tracheobronchial tree immediately after admission to ICU and endotracheal intubation( ETI) , and afterward twice weekly. The patients were divided naturally into three groups according to airway bacterial colonization. Their baseline characteristics, APACHEⅡ score, intubation status and therapeutic interventions, etc. were recorded and analyzed. Results In the total 78 ventilated patients, the incidence of lower airway colonization and VAP was 83. 3% and 23. 1% , respectively. The plasma albumin( ALB) ≤29. 6 g/L( P lt; 0. 05) , intubation attempts gt; 1( P lt; 0. 01) were risk factors for lower airway colonization. In the patients with lower airway colonization, preventive antibiotic treatment, applying glucocorticoid and prealbumin( PA) ≤ 69. 7 mg/L were risk factors for VAP ( P lt; 0. 05) . Conclusions The risk factors for lower airway colonization in ventilated patients were ALB≤29. 6 g/L and intubation attempts gt; 1. And for lower airway colonized patients, PA ≤ 69. 7 mg/L, preventive antibiotic treatment and applying glucocorticoid were risk factors for VAP.

          Release date:2016-09-13 03:51 Export PDF Favorites Scan
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