机械通气患者计划性脱机与经验性脱机的比较  

A comparison of two methods of planning and experience-based ventilator weaning with MV patients

作　　者：郭炜妍 王宝华[1] 唐明贵[1] 白静[1] 王印华[1] 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：《宁夏医学杂志》2015年第7期611-614,共4页Ningxia Medical Journal

基　　金：河北省唐山市科技计划项目(12140209A-66)

摘　　要：目的比较不同方式下计划性脱机与经验性脱机的优劣。方法选取166例行有创机械通气患者并进行随机分组,做病例与对照研究。结果试验组开始脱机前接受机械通气(MV)时间明显短于对照组(P<0.05),脱机成功率明显优于对照组(P<0.05),ICU住院费用试验组明显低于对照组(P<0.05),但2组在ICU住院时间、总住院时间及ICU死亡率、总住院死亡率方面比较差异无统计学意义(P>0.05)。在机械通气并发症方面,试验组VAP发生率明显低于对照组(P<0.05),而气管切开MV>21 d、48 h内再插管、患者自我拔管2组间比较差异无统计学意义。结论采用计划性脱机的试验组,有可能缩短机械通气持续时间,减少住院费用及降低相关并发症的发生。Objective To compare the difference between planning ventilator weaning and experience- based ventilator weaning. Methods 166 patients with invasive mechanical ventilation（ MV） were selected and randomly divided into two groups for case-control study. Results The MV time of before weaning which experience- based group spent was shorter than the control group spent（ P〈0. 05）. Compared with success rate,experience- based group was better than the control group（ P〈0. 05）. Meanwhile,ICU hospitalization expenses of experience- based group patients spent less compared with control group（ P〈0. 05）. However,two groups had no obvious difference in length of hospital stay in the ICU,and a total length of hospital stay and ICU mortality and total hospital mortality（ P〈0. 05）. In terms of mechanical ventilation complications,the experimental group significantly lower than control group in incidence of VAP（ P〈0. 05）. There was no obvious difference between the two groups in tracheotomy,MV 21 days,reintubation within 48 h,patient- self drawing tube. Conclusion The method of planning ventilator weaning may shortened the duration of mechanical ventilation,and reduced the hospitalization expenses and reduced the related complications.

关 键 词：机械通气 脱机 

分 类 号：R459.7[医药卫生—急诊医学]