呼吸机计划性脱机的研究进展  

The Research Progress of Weaning Planning in the Mechanical Ventilation

作　　者：王宝华[1] 郭炜妍 浦践一[1] 

机构地区：[1]河北联合大学附属医院重症医学科,河北唐山063000

出　　处：《医学综述》2015年第2期274-276,共3页Medical Recapitulate

基　　金：唐山市科技计划(12140209A-66)

摘　　要：机械通气在挽救患者性命的同时,还带来了很多负面作用,因此积极的脱机显得非常重要。当患者病情改善,就应准备进入自主呼吸试验(SBT)。脱机参数尤其是浅快呼吸指数和呼吸道闭合压对脱机有很好的指导价值。目前常用的脱机方法有SBT法、有创-无创序贯通气法和电脑智能法。其中SBT法是目前使用较多的脱机方法,它又包括压力支持通气、持续呼吸道正压通气和T管试验。有创-无创序贯通气法适用于拔管后呼吸窘迫的患者,并且拔管后立即使用才能获益。电脑智能法便于操作,临床效果有待研究。Mechanical ventilation brings many negative effects though it saves life,therefore the positive weaning is very important. When the patients＇ condition has improved,we should be ready to begin a spontaneous breathing trial. Weaning parameter especially the shallow quick breathing index and airway occlusion pressure have very good guidance value to weaning. The common weaning methods in use are spontaneous breathing trial（ SBT）,invasive-noninvasive sequential ventilation and smart-care ventilation. SBT method is a more often used method,which includes pressure support ventilation,continuous positive airway pressure and T tube test. Invasive-noninvasive sequential ventilation is suitable for the patients with respiratory distress after extubation,and it is only beneficial in immediately use after extubation. Smart-care ventilation is convenient for operation,but the clinical results need further studies.

关 键 词：机械通气 脱机 自主呼吸试验 

分 类 号：R459.7[医药卫生—急诊医学]