综合脱机指数、用力呼吸指数和气道闭合压对COPD困难脱机患者撤机预测价值研究  

Research about the value of integrated weaning index,breathing hard index and airway occlusion pressure predicting the weaning success rate of patients with COPD and difficult weaning

作　　者：刘毅君[1] 龙宏杰[1] 

机构地区：[1]惠州市第三人民医院ICU,广东惠州516008

出　　处：《现代医学》2016年第10期1382-1385,共4页Modern Medical Journal

基　　金：惠州市科技计划项目(2015Y137)

摘　　要：目的:探讨综合脱机指数(IWI)、用力呼吸指数(CORE)和气道闭合压(P0.1)对慢性阻塞性肺疾病(COPD)困难脱机患者撤机预测价值。方法:以机械通气治疗时间大于72 h的80例COPD患者为研究对象,每日行撤机筛查实验,符合条件者行30 min自主呼吸实验(SBT),统计撤机成功率,并分析IWI、CORE和P0.1与COPD困难脱机患者撤机成功率的关系及其单独和联合预测患者撤机成功率的价值。结果:患者撤机成功率为80.00%。与撤机失败者比较,撤机成功者的IWI和CORE均升高,P0.1则降低(P<0.05)。IWI、CORE、P0.1与COPD困难脱机患者撤机成功率均相关,且三者联合预测COPD困难脱机患者撤机成功率的价值良好。结论:IWI、CORE和P0.1联合预测COPD困难脱机患者撤机成功的价值良好,可作为其撤机评估的参考指标。Objective： To evaluate the value of integrated weaning index（ IWI）,breathing hard index（ CORE）and airway occlusion pressure（ P0. 1） predicting the weaning success rate of patients with chronic obstructive pulmonary disease（ COPD） and difficult weaning. Methods： 80 cases of COPD patients who had mechanical ventilation treatment longer than 72 h were selected as the research object,and had the daily weaning screening experiment. The patients qualified the weaning screening had 30 min spontaneous breathing test（ SBT）. Waning success rate of the patients was statistically calculated and the relationship between IWI,CORE and P0. 1 with the weaning success rate of COPD patients with difficult weaning and the value of IWI,CORE and P0. 1 alone and unitedly predicting weaning success rate of the patients were analyzed. Results： Weaning success rate of the patients was 80. 00%. Compared with patients with failure weaning,IWI and CORE of the COPD patients with successful weaning were higher while P0. 1 was lower（ P 〈 0. 05）. IWI,CORE and P0. 1 were correlated with the weaning successful rate of COPD patients and the value of IWI,CORE and P0. 1 unitedly predicting weaning successful rate of COPD patients with difficult weaning was fine. Conclusion： Value of IWI,CORE and P0. 1 in COPD patients unitedly predicting weaning success of COPD patients with difficult weaning is fine and they can be taken as reference indexes for predicting the weaning success of COPD patients with difficult weaning.

关 键 词：综合脱机指数 用力呼吸指数 气道闭合压 慢性阻塞性肺疾病 困难脱机 撤机 预测 

分 类 号：R563[医药卫生—呼吸系统]