脱机后剪短气管插管对慢性阻塞性肺疾病急性加重患者脱机成功率的影响  

The success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease patients influenced by bobbed endotracheal intubation

作　　者：张辉[1] 张学平[1] 张玉昌[1] 班存芳[1] 王炳华[1] 

机构地区：[1]山东省滨州市中心医院重症医学科,251700

出　　处：《中国医师进修杂志》2016年第10期938-940,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨脱机后剪短气管插管对慢性阻塞性肺疾病急性加重（AECOPD）患者脱机成功率的影响。方法将116例行有创机械通气且已符合撤机标准的AECOPD患者按随机数字表法分为对照组（普通气管插管组）和试验组（剪短气管插管组），每组58例，比较两组撤机前和拔管前呼吸、心率、浅快呼吸指数、氧合指数、脉搏血氧饱和度、潮气量及脱机成功率。结果试验组拔管前呼吸、心率、浅快呼吸指数明显低于对照组[（19.7±2.3）次/min比（23.5±2.3）次/min、（91.2±6.3）次/min比（93.4±8.1）次/min、80.2±6.7比90.5±9.6]，氧合指数、脉搏血氧饱和度、潮气量和脱机成功率明显高于对照组[（269±9）mmHg（1 mmHg=0.133 kPa）比（245±16）mmHg、0.929±0.014比0.870±0.037、（6.1±1.2）ml/kg 比（5.1±0.8）ml/kg、91.38%（53/58）比77.59%（45/58）]，差异有统计学意义（P＜0.05）。结论剪短气管插管可提高患者脱机成功率。Objective To study the success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） patients influenced by bobbed endotracheal intubation. Methods One hundred and sixteen AECOPD patients who were given invasive mechanical ventilation and reached the standards of off-ventilator were divided into control group （general endotracheal intubation group） and experiment group bobbed （tracheal intubation） by random digits table method with 58 cases each. The respiratory rate （RR）, heart rate （HR）, rapid and shallow breathing index （RSBI）, oxygenation index （OI）, pulse blood oxygen saturation （SpO2）, tidal volume and success rate of ventilator weaning were compared. Both groups were implemented of extubation if they reached the standards of the extubation time by observing their ability in spontaneous breathing test （SBT）. Results The RR, HR and RSBI before extubation in experiment group were significantly lower than those in control group：（19.7 ± 2.3） times/min vs. （23.5 ± 2.3） times/min, （91.2 ± 6.3） times/min vs. （93.4 ± 8.1） times/min and 80.2 ± 6.7 vs. 90.5 ± 9.6, P〈0.05, and the OI, SpO2, tidal volume and success rate of ventilator weaning were significantly higher than those in control group： （269 ± 9） mmHg （1 mmHg = 0.133 kPa） vs. （245 ± 16） mmHg, 0.929 ± 0.014 vs. 0.870 ± 0.037, （6.1 ± 1.2） ml/kg vs. （5.1 ± 0.8） ml/kg and 91.38%（53/58） vs. 77.59%（45/58）, P〈0.05. Conclusions The bobbed endotracheal intubations can improve the success rate of ventilator weaning in patients with AECOPD.

关 键 词：肺疾病 慢性阻塞性 插管法 气管内 通气机撤除法 

分 类 号：R563.9[医药卫生—呼吸系统]