【摘要】：目的探討急診ICU(EICU)中序貫通氣治療的慢性阻塞性肺疾病急性發(fā)作(AECOPD)患者撤機時機的選擇,分析影響機械通氣持續(xù)時間的因素。方法選取2012年4月至2014年4月中國醫(yī)科大學附屬第一醫(yī)院EICU收治的經(jīng)有創(chuàng)-無創(chuàng)序貫通氣治療的AECOPD患者132例,收集患者的一般情況、機械通氣時間、淺快呼吸指數(shù)(RSBI)、急性生理學和慢性健康狀況Ⅱ(APACHEⅡ)評分、自主排痰能力、血氣分析、血漿前白蛋白(pre-ALB)水平、腦鈉肽(BNP)、降鈣素原(PCT)等指標。對各項指標進行單因素分析,并將具有統(tǒng)計學意義的指標納入Logistic回歸分析。結(jié)果 132例患者中,96例(72.7%)需要≤7 d的有創(chuàng)呼吸機輔助通氣,19例(14.3%)需要7 d的有創(chuàng)呼吸機輔助通氣;115例撤機成功的患者中83例(72.1%)首次撤機即成功。對于有自主排痰能力的患者,以RSBI95 bpm/L、APACHEⅡ評分23為指標預測首次撤機成功的敏感度為91.6%,特異度為62.5%。機械通氣持續(xù)時間與p H、Pa CO2無相關性(P0.05),與血漿pre-ALB水平(OR:0.31,95%CI:0.21~0.63,P=0.03)、BNP(OR:3.43,95%CI:12.33~16.43,P=0.01)、PCT(OR:3.67,95%CI:1.90~2.11,P=0.01)以及APACHEⅡ評分(OR:2.89,95%CI:1.10~2.87,P=0.01)相關。結(jié)論在EICU中大多數(shù)經(jīng)有創(chuàng)-無創(chuàng)序貫通氣治療的AECOPD患者基本可以在7 d內(nèi)完成撤機,綜合RSBI、APACHEⅡ評分和患者自主排痰能力有助于撤機時機的選擇。
[Abstract]:Objective to investigate the timing of withdrawal in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated with sequential ventilation in emergency ICU (EICU), and to analyze the factors influencing the duration of mechanical ventilation. Methods from April 2012 to April 2014, 132 AECOPD patients treated with invasive and noninvasive sequential ventilation in the first affiliated Hospital of China Medical University (EICU) were selected. The general condition, mechanical ventilation time and shallow fast respiratory index (RSBI),) of the patients were collected. Acute physiology and chronic health status 鈪，

本文編號：2461093