超声膈肌功能评估在指导重症COPD机械通气患者撤机中的应用  

Application of Ultrasonic Diaphragm Function Evaluation in the Guidance of Weaning from Mechanical Ventilation in Patients with Severe COPD

作　　者：张声[1] 张卫星[1] 林影芯[1] ZHANG Sheng ZHANG Weixing LIN Yingxin(Intensive Care Unit, Shenzhen Hospital of Peking University, Shenzhen 518000, China)

机构地区：[1]北京大学深圳医院重症医学科,广东深圳518000

出　　处：《临床医学工程》2017年第8期1051-1052,共2页Clinical Medicine & Engineering

摘　　要：目的探讨重症COPD机械通气患者撤机中超声膈肌功能评估的指导作用。方法以2014年1月到2016年12月期间我院收治的90例重症COPD机械通气撤机患者为研究对象,其中撤机成功的48例为观察组,撤机失败的42例为对照组,两组患者均通过自主呼吸实验(SBT)进行超声膈肌功能评估,回顾分析两组患者的超声评估资料。结果观察组在不同时间段的右侧膈肌位移显著大于对照组,膈肌收缩速度显著小于对照组,差异有统计学意义(P<0.05)。结论对重症COPD机械通气患者采用超声膈肌功能评估能够有效地指导患者的撤机,提高撤机成功率,其中临界条件为右侧膈肌位移大于1.14 mm,膈肌收缩速度不超过1.46 cm/s,预测价值较高,可结合其他指标进行联合应用。Objective To explore the role of ultrasonic diaphragm function evaluation in the guidance of weaning from mechanical ventilation in patients with severe COPD. Methods 120 cases of patients with severe COPD who received mechanical ventilation wearing in our hospital from January 2014 to December 2016 were selected as research objects. 48 cases of successful weaning were set as the observation group, and 42 cases of fail weaning were set as the control group. The ultrasonic diaphragm function was assessed by spontaneous breathing test （SBT） and the related data were retrospectively analyzed. Results The displacement of right diaphragm at different time periods of observation group were significantly higher than those of control group, and the diaphragm contraction velocity were significantly lower than those of control group （P 〈0.05）. Conclusions Evaluation of diaphragm function by ultrasound can effectively guide the wearing of severe COPD patients with mechanical ventilation and improve the success rate of weaning. The critical condition for the right diaphragmatic displacement is greater than 1.14 mm, and the diaphragmatic contraction velocity is not more than 1.46 ends. The forecast value is high, and this method can be combined with other indexes.

关 键 词：超声膈肌功能评估 重症COPD 机械通气 撤机 

分 类 号：R563[医药卫生—呼吸系统]