Objective:To investigate the influence factors of ventilator weaning outcome in patients undergoing mechanical ventilation after surgery.Methods:The clinical data of 87 patients undergone postoperative mechanical ventilation and admitted to Intensive Care Unit(ICU) in Jinhua People's Hospital from January 1, 2017 to July 31, 2018 were retrospectively analyzed.The patients were divided into successful group (57 cases) and failure group (30 cases) according to the weaning outcome.The basic clinical data of the patients were collected, including gender, age, whether they had underlying disease or not and whether it was emergency operation or not.The levels of albumin(ALB), white blood cells(WBC), hemoglobin(HB), platelets(Plt), oxygen partial pressure(PaO 2), carbon dioxide partial pressure (PaCO 2), oxygenation index(OI), lactate(Lac) and mechanical ventilation time(T) of the patients within 24h of ICU admission after operation were recorded, and the acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ) score worst value score of the patients within 24h of ICU admission was calculated.The risk factors affecting the weaning outcome after operation were analyzed using univariate analysis and logistic regression analysis. Results:The creatinine, APACHEⅡ score, Lac, PaCO 2 in the successful group were 66.60mol/L, (21.67±4.67)points, 2.60mmol/L, 34.50mmHg, respectively, which in the failure group were 79.00mol/L, (25.73±4.27) points, 5.00mmol/L, 37.80mmHg, respectively, and the differences between the two groups were statistically significant ( t=2.224, 3.975, 2.609, 2.001, P=0.026, <0.001, 0.009, 0.045). The single factor analysis showed that the ventilator weaning outcome in patients undergoing mechanical ventilation after surgery was related with creatinine, APACHEⅡ score, Lac, PaCO 2.Logistic regression analysis showed that the APACHE Ⅱ grade B value was 0.174, Wald value of 6.845, P=0.009<0.05, suggested that APACHEⅡ score was the independent risk factor for surgery patients withdraw machine failure.Draw the APACHEⅡ score ROC curve, the area under the curve was 0.734, the curve of cut-off point was 22.95, the corresponding sensitivity and specificity were 59.60% and 73.30% respectively. Conclusion:APACHEⅡ score is an independent risk factor affecting postoperative weaning outcome, it can help to predict the weaning outcome of patients undergoing mechanical ventilation after surgery, but its sensitivity is not high.

Objective To investigate the predictive value of lactate/albumin(L/A)and C-reactive protein(CRP)for 90-day mortality risk in patients with sepsis.Methods Clinical data from 125 patients diagnosed with sepsis in the Comprehensive Intensive Care Unit,Jinhua People's Hospital from February 2021 to February 2024 retrospectively were collected.According to 90-day death or not of patients,they were divided into death group(n=61)and survival group(n=64).Independent risk factors for 90-day mortality in patients with sepsis were analyzed by using multivariate Logistic regression.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of L/A,CRP,and L/A combined CRP for 90-day mortality in patients with sepsis.At the same time,subgroup analysis of patients was performed according to the best cut-off value,and Kaplan-Meier survival curves were drawn.Results Multivariate Logistic regression analysis showed that high CRP(OR=1.009,95％CI:1.003-1.015,P=0.006),high L/A(OR=1.449,95％CI:1.050-2.000,P=0.024),and concurrent acute kidney injury(OR=2.890,95％CI:1.198-6.975,P=0.018)were independent risk factors for 90-day mortality in patients with sepsis.Area under the curve(AUC)for predicting 90-day mortality in patients with sepsis by using CRP,L/A,and L/A combined with CRP were 0.645,0.612 and 0.708 respectively.Subgroup analysis showed that 90-day mortality of patients with sepsis in L/A＞1.41 group was significantly higher than that in L/A≤1.41 group(P=0.001),and 90-day mortality of patients with sepsis in CRP＞93.29mg/L group was significantly higher than that in CRP≤93.29mg/L group(P=0.001),which was consistent with the analysis results of Kaplan-Meier survival curve.Conclusion Both L/A and CRP have certain predictive value for 90-day prognosis of patients with sepsis,and their combined predictive effect is better.