影响新生儿机械通气拔管失败因素及护理  

Analysis of the factors to lead to the failure of extubation in neonate with mechanical ventilation and nursing care

作　　者：孙献梅[1] 董爱兰[1] 彭艳[1] 

机构地区：[1]山东大学附属省立医院,山东济南250021

出　　处：《齐鲁护理杂志》2010年第7期1-4,共4页Journal of Qilu Nursing

摘　　要：目的:探讨影响新生儿机械通气拔管失败的相关因素及机械通气的护理方法。方法:回顾性分析191例机械通气新生儿临床资料,按拔管结局分为成功组和失败组,分析影响新生儿机械通气拔管失败的因素。结果:①拔管成功组144例,失败组47例,失败率为24.61%。②胎龄、低体重与拔管失败显著相关,缺氧缺血性脑病(HIE)程度越重,越容易拔管失败。③上机体重、插管次数、意外脱管次数、抢救次数、吸痰次数、导管插入深度、与拔管失败显著相关。④PEEP、机控呼吸、VE与拔管失败显著相关。结论:胎龄小、低体重可导致拔管失败,HIE程度越重越容易拔管失败;拔管及机械通气撤离的成败与原发病的性质及轻重程度关系最密切;上机体重、插管次数、意外脱管次数、抢救次数、吸痰次数、导管插入深度可导致拔管失败。Objective： To discuss the factors to lead to the failure of extubation in neonate with mechanical ventilation and nursing methods.Methods： The clinical data of 191 neonates with mechanical ventilation were retrospectively analyzed and the 191 neonates were divided into success and failure groups according to the outcomes of extubation and the factors of failure of ex-tubation were further analyzed.Results： The successful extubation was found in 144 cases of the success group and failed extubation in 47 cases of the failure group,the failure rate was 24.61%.The gestational age and low body weight was significantly correlated to extubation failure;the more severe the hypoxic ischemic encephalopathy（HIE） is,the more likely extubation failure occurs;the calculated weight for mechanical ventilation,intubation times,the numbers of accidentally detachment of tube,rescue frequency,the numbers of suction and catheter insertion depth were significantly related to extubation failure;PEEP,machine control breathing and VE were significantly associated with extubation failure.Conclusion： The little gestational age and low body weight may lead to extubation failure and the results mentioned above are the main factors to cause extubation failure in the neonates with mechanical ventilation.

关 键 词：拔管失败 新生儿 机械通气 

分 类 号：R473.72[医药卫生—护理学]