發(fā)布時間：2018-03-11 18:40

  本文選題：機械通氣　切入點：撤機　出處：《中國實用內科雜志》2014年05期 　論文類型：期刊論文

【摘要】：目的評估自主呼吸試驗(SBT)安全性篩查寬松標準在重癥監(jiān)護病房(ICU)撤機中應用的效用及其安全性。方法選取2010年12月至2011年5月入住浙江省中醫(yī)院ICU的82例需行有創(chuàng)機械通氣的患者,采用隨機雙盲對照的方法分為SBT安全性篩查寬松標準組(寬松標準組)42例和SBT安全性篩查傳統標準組(傳統標準組)40例。篩選后行SBT。試驗通過則書面通知管床醫(yī)生SBT安全性篩查標準結果,由管床醫(yī)生決定何時撤機拔管。比較兩組間的脫機狀態(tài)維持時間、機械通氣時間、ICU住院時間、28 d病死率、意外拔管和再插管率。結果寬松標準組較傳統標準組脫機狀態(tài)維持時間更長(25 d對21 d,P=0.000),機械通氣時間縮短(3 d對7.5 d,P=0.000),ICU住院時間縮短(11 d對17 d,P=0.001),28 d病死率更低(14.3%對35.0%,P=0.029),意外拔管率(2.4%對7.5%,P=0.574)、再插管率(9.5%對7.5%,P=1.000)差異無統計學意義。結論 SBT安全性篩查寬松標準比SBT安全性篩查傳統標準更有優(yōu)越性,可以作為常規(guī)篩選標準應用于臨床。
[Abstract]:Objective to evaluate the efficacy and safety of relaxed safety screening criteria for spontaneous respiratory test (SBT) in patients with ICU in intensive care unit (ICU). Methods 82 cases of ICU admitted to Zhejiang traditional Chinese Medicine Hospital from December 2010 to May 2011 were selected. Patients with mechanical ventilation, The randomized double-blind control method was used to divide the SBT safety screening system into two groups: the loose standard group (42 cases) and the traditional SBT safety screening group (40 cases). Results of SBT safety screening standard, The weaning and extubation time and mechanical ventilation time of the two groups were compared, and the mortality rate of ICU was 28 days. Results the maintenance time of off-line state in the loose standard group was longer than that in the traditional standard group, and the duration of mechanical ventilation was shorter than that of the traditional standard group. The duration of mechanical ventilation was shortened by 3 days to 7.5 days, and the ICU hospitalization time was shortened by 11 days to 17 days, the mortality rate was lower than that of the traditional standard group. The mortality rate was 14.3% lower than that of the traditional standard group. There was no significant difference in the rate of accidental extubation (2.4% vs 7.5g) and the rate of re-intubation (9.5% vs 7.5p 1.000). Conclusion the loose standard of SBT safety screening is superior to the traditional standard of SBT safety screening. It can be used as a routine screening criterion in clinic.
【作者單位】： 浙江省中醫(yī)院ICU;浙江大學醫(yī)學院附屬婦產科醫(yī)院影像科;溫州醫(yī)學院附屬第一醫(yī)院ICU;
【基金】：浙江省中醫(yī)藥重點學科建設計劃-中西醫(yī)結合重癥醫(yī)學(2012-XK-A12)
【分類號】：R563.8

【參考文獻】

相關期刊論文 前2條

1 田慶;趙微;王巧云;陳良安;;程序化撤機策略在COPD患者中的應用[J];解放軍醫(yī)學雜志;2007年05期

2 羅群;農凌波;;慢性阻塞性肺疾病撤機困難呼吸力學特征10例分析[J];中國實用內科雜志;2012年02期

【共引文獻】

相關期刊論文 前10條

1 方業(yè)香;;程序化脫機拔管在機械通氣撤離中的應用[J];當代護士(下旬刊);2012年07期

2 王燕;山峰;杜春艷;;鎮(zhèn)靜治療在ICU的應用[J];青島大學醫(yī)學院學報;2014年03期

3 李德平;;ICU機械通氣患者撤機的研究進展[J];大家健康(學術版);2011年19期

4 劉芳印;;呼吸機撤機失敗相關因素及護理干預[J];河北醫(yī)藥;2013年24期

5 郝芬;;應用循證護理降低呼吸機相關肺炎的研究進展[J];護理實踐與研究;2014年02期

6 王曉川;丁勁松;胡良安;;機械通氣撤機過程中兩種脫機方法的對比性研究[J];實用醫(yī)學雜志;2008年14期

7 劉京菊;沈h牖，

本文編號：1599416