本文選題：機(jī)械通氣　切入點(diǎn)：撤機(jī)　出處：《中國(guó)實(shí)用內(nèi)科雜志》2014年05期 　論文類型：期刊論文

【摘要】：目的評(píng)估自主呼吸試驗(yàn)(SBT)安全性篩查寬松標(biāo)準(zhǔn)在重癥監(jiān)護(hù)病房(ICU)撤機(jī)中應(yīng)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(jī)械通氣的患者,采用隨機(jī)雙盲對(duì)照的方法分為SBT安全性篩查寬松標(biāo)準(zhǔn)組(寬松標(biāo)準(zhǔn)組)42例和SBT安全性篩查傳統(tǒng)標(biāo)準(zhǔn)組(傳統(tǒng)標(biāo)準(zhǔn)組)40例。篩選后行SBT。試驗(yàn)通過(guò)則書(shū)面通知管床醫(yī)生SBT安全性篩查標(biāo)準(zhǔn)結(jié)果,由管床醫(yī)生決定何時(shí)撤機(jī)拔管。比較兩組間的脫機(jī)狀態(tài)維持時(shí)間、機(jī)械通氣時(shí)間、ICU住院時(shí)間、28 d病死率、意外拔管和再插管率。結(jié)果寬松標(biāo)準(zhǔn)組較傳統(tǒng)標(biāo)準(zhǔn)組脫機(jī)狀態(tài)維持時(shí)間更長(zhǎng)(25 d對(duì)21 d,P=0.000),機(jī)械通氣時(shí)間縮短(3 d對(duì)7.5 d,P=0.000),ICU住院時(shí)間縮短(11 d對(duì)17 d,P=0.001),28 d病死率更低(14.3%對(duì)35.0%,P=0.029),意外拔管率(2.4%對(duì)7.5%,P=0.574)、再插管率(9.5%對(duì)7.5%,P=1.000)差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 SBT安全性篩查寬松標(biāo)準(zhǔn)比SBT安全性篩查傳統(tǒng)標(biāo)準(zhǔn)更有優(yōu)越性,可以作為常規(guī)篩選標(biāo)準(zhǔn)應(yīng)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(xué)醫(yī)學(xué)院附屬婦產(chǎn)科醫(yī)院影像科;溫州醫(yī)學(xué)院附屬第一醫(yī)院ICU;
【基金】：浙江省中醫(yī)藥重點(diǎn)學(xué)科建設(shè)計(jì)劃-中西醫(yī)結(jié)合重癥醫(yī)學(xué)(2012-XK-A12)
【分類號(hào)】：R563.8

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本文編號(hào)：1599416