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[1998年至2003年北京重症监护病房急性呼吸窘迫综合征的流行病学调查]

[Epidemiological investigation on acute respiratory distress syndrome occurring in intensive care units in Beijing from 1998 to 2003].

作者信息

Ge Qing-gang, Zhu Xi, Yao Gai-qi, Wang Chao, Yin Cheng-hong, Lü Jing-qiao, Zhang Shu-wen

机构信息

Intensive Care Unit, The Third Hospital, Peking University, Beijing, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007 Apr;19(4):201-4.

Abstract

OBJECTIVE

To investigate incidence, causes and mortality of acute respiratory distress syndrome (ARDS) in intensive care units (ICU) in Beijing.

METHODS

Patients in ICU of eight general hospitals in Beijing from May 1998 to April 2003 were retrospectively studied. ARDS was diagnosed according to the 1994 American-European consensus conference criteria. Results Of 8 482 patients admitted to ICUs in the same period, there were 383 patients (4.5%) diagnosed as having ARDS. Major primary diseases for ARDS were sepsis (21.7%), pneumonia (16.2%), surgical operation (13.1%), acute pancreatitis (12.8%) and multiple severe trauma (10.7%). The mean interval between onset of the primary disease and onset of ARDS was (61.8 +/- 43.7) hours. The overall mortality of ARDS was 52.0%, the mortality adjusted for age (< or =39, 40-64, > or =65 years old) and gender (male) showed significant changes in each year (all P<0.05), but acute physiology and chronic health evaluation II (APACHE II, < or =12, 13-19, > or =20 scores) score showed no significant changes during the 5 years. Septic shock (36.2%) and heart failure (20.6%) were major lethal causes, while only 14.6% died of respiratory failure.

CONCLUSION

ARDS was frequent in ICU in Beijing, the mortality remains high, and there is no tendency to decline in recent years.

摘要

目的

调查北京重症监护病房(ICU)中急性呼吸窘迫综合征(ARDS)的发病率、病因及死亡率。

方法

对1998年5月至2003年4月期间北京8家综合医院ICU的患者进行回顾性研究。ARDS根据1994年美欧共识会议标准进行诊断。结果在同期入住ICU的8482例患者中,有383例(4.5%)被诊断为ARDS。ARDS的主要原发疾病为脓毒症(21.7%)、肺炎(16.2%)、外科手术(13.1%)、急性胰腺炎(12.8%)和多发性严重创伤(10.7%)。原发疾病发作至ARDS发作的平均间隔时间为(61.8±43.7)小时。ARDS的总体死亡率为52.0%,按年龄(≤39岁、40 - 64岁、≥65岁)和性别(男性)调整后的死亡率在各年份有显著变化(均P<0.05),但急性生理与慢性健康状况评分系统II(APACHE II,≤12分、13 - 19分、≥20分)评分在5年期间无显著变化。感染性休克(36.2%)和心力衰竭(20.6%)是主要致死原因,而仅14.6%死于呼吸衰竭。

结论

ARDS在北京的ICU中较为常见,死亡率仍然很高,且近年来无下降趋势。

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