浅快呼吸指数在预测呼吸机撤离中的价值  

Application of Rapid Shallow Breathing Index in Predicting for Weaning Patients from Mechanical Ventilation

作　　者：马玉杰[1] 杨晓军[1] 曹相原[1] 

机构地区：[1]宁夏医学院附属医院 ICU,银川750004

出　　处：《宁夏医学院学报》2008年第3期312-313,346,共3页Journal of Ningxia Medical College

摘　　要：目的探讨浅快呼吸指数(Rapid Shallow Breath Index,RSBI)在加强医疗病房(Intensive Care Unit,ICU)机械通气超过72h的患者撤离呼吸机的预测作用。方法采用前瞻性研究方法,对满足常规撤机标准的33例患者,进行120min自主呼吸试验(Spontaneous Breath Trial,SBT)并动态监测5、15、30,60、120min五个时点的RSBI,根据撤机结果分为撤机成功组和撤机失败组。应用SPSS 15.0统计软件对数据进行统计分析。结果23例患者完成了120min SBT,其中有12例撤机失败。在SBT 5min和SBT 15min时候,RSBI在撤机成功组和撤机失败组之间没有统计学意义(P>0.05),而在SBT 30min及SBT 30min以后时点撤机失败组的RSBI明显高于撤机成功组的RSBI (P<0.05)。5个时点的RSBI的ROC下面积分别为0.52、0.71、0.91、0.96、0.99。结论在ICU中,对机械通气超过72h以上的患者撤离呼吸机的时候,SBT 2h时的RSBI较之前的RSBI具有更高的预测价值。Objective To evaluate the effects of Rapid Shallow Breathing Index （RSBI） in the weaning process for patients undergoing prolonged mechanical ventilation in Intensive Care Unit （ICU）. Methods Prospective study was performed. 33 patients satisfied the traditional weaning predictors took 120min Spontaneous Breathing Trial （SBT）. RSBI were continuously monitored by ventilator. 33 patients were divided into the success and failure groups according to the result. Results Twenty-three patients passed 120min SBT and twelve patients failed weaning. There was no difference of RSBI between the success group and the failure group at 5min and 15min during SBT, but there was significant difference of RSBI between the two groups after 30 min during SBT, and 2 h RSBI was found the most difference during SBT. 5 times＇ ROC of RSBI was 0.51,0.71,0.91,0.96, and 0.99, respectively. Conclusion In the weaning process for patients undergoing prolonged mechanical ventilation,2h RSBI is more valuable than the other times＇ RSBI.

关 键 词：浅快呼吸指数 机械通气 呼吸机撤离 

分 类 号：R563.8[医药卫生—呼吸系统]