重庆医学2026，Vol.55Issue(4)：853-858,6.DOI:10.3969/j.issn.1671-8348.2026.04.022
老年AECOPD合并呼吸衰竭患者无创呼吸机撤机失败的危险因素分析
Analysis of risk factors for noninvasive ventilator weaning failure in elderly AECOPD patients complicated with respiratory failure
摘要
Abstract
Objective To investigate the risk factors for non-invasive ventilation(NIV)weaning failure in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated by respiratory failure.Methods A retrospective analysis was conducted on the clinical data of 103 elderly pa-tients with AECOPD combined with respiratory failure who were hospitalized at the Yongchuan District Peo-ple's Hospital in Chongqing from 2022 to 2023.According to the NIV weaning outcome,the patients were di-vided into a success group(n=73)and a failure group(n=30).The general data,laboratory test indicators,blood gas analysis indicators,and ventilator parameters and usage were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for NIV weaning failure in elderly patients with AECOPD combined with respiratory failure.Results The age of the failure group was higher than that of the success group in elderly patients with AECOPD.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,the proportions of patients with comorbid heart failure,coronary heart disease and diabetes,and the levels of WBC,neutrophil percentage,C-reactive protein(CRP),procalcito-nin(PCT),D-dimer(D-D),blood lactate,N-terminal pro-brain natriuretic peptide(NT-proBNP),serum po-tassium,and arterial partial pressure of carbon dioxide(PaCO2)were higher in the failure group than in the success group.The Glasgow Coma Scale(GCS)score,pH,arterial partial pressure of oxygen(PaO2),and ox-ygenation index[PaO2/inspired oxygen fraction(FiO2)]were lower in the failure group than in the success group.The duration of non-invasive ventilation(NIV)use was longer in the failure group than in the success group.All these differences were statistically significant(P<0.05).Multivariate logistic regression analysis revealed that a high APACHE Ⅱ score,comorbid heart failure,high levels of CRP,PCT,NT-proBNP,and PaCO2,and a long duration of NIV use were independent risk factors for NIV weaning failure in elderly pa-tients with AECOPD complicated with respiratory failure(P<0.05),while a high GCS score was a protective factor(P<0.05).Conclusion Weaning failure from NIV in elderly AECOPD patients with respiratory fail-ure is associated with multiple factors.Clinically,these factors should be comprehensively assessed to develop individualized weaning strategies,optimize treatment,and monitor closely,with the aim of improving patient prognosis.关键词
老年/慢性阻塞性肺疾病急性加重期/呼吸衰竭/无创呼吸机/撤机失败/危险因素Key words
old age/acute exacerbation of chronic obstructive pulmonary disease/respiratory failure/non-invasive ventilator/weaning failure/risk factors分类
医药卫生引用本文复制引用
王利,何菲..老年AECOPD合并呼吸衰竭患者无创呼吸机撤机失败的危险因素分析[J].重庆医学,2026,55(4):853-858,6.基金项目
重庆市永川区技术创新与应用发展专项面上项目(2021yc-cxfz30017). （2021yc-cxfz30017）
