小儿先天性心脏病术后两种不同撤机方法的效果比较  

Comparison of two different weaning methods in children after surgery for congenital heart disease

作　　者：潘晓兰[1] 李秀红[1] 孟保英[1] 高乐[1] 

机构地区：[1]深圳市儿童医院心外科,广东深圳518026

出　　处：《海南医学》2017年第15期2575-2577,共3页Hainan Medical Journal

基　　金：广东省深圳市科技计划项目(编号:201103142)

摘　　要：目的比较小儿先天性心脏病术后呼吸机智能模式撤机法与医师经验撤机法的效果。方法选取2013年5月至2015年5月深圳市儿童医院心外科收治的92例先天性非紫绀型心脏病患儿作为研究对象,按术后不同撤机方式分为两组,观察组50例给予呼吸机智能模式撤机,对照组42例采用医师经验撤机。比较两种撤机方法的撤机时间、撤机成功率、重置管率及撤机前后30 min机体生命体征的变化。结果观察组患者所需的撤机时间为(0.59±0.16)d,明显少于对照组的(1.04±0.21)d,差异有显著统计学意义(P<0.01);两组患者撤机前后的心率、血压及呼吸的变化值比较差异均无统计学意义(P>0.05),而氧合指数(OI)、二氧化碳分压(PaCO_2)及酸碱度(p H值)比较差异均有统计学意义(P<0.05);观察组患者的撤机成功率为88.0%,明显高于对照组的69.0%,差异有统计学意义(P<0.05)。结论先天性心脏病术后呼吸机智能撤机法能够缩短呼吸机辅助时间和提高撤机成功率,值得推广。Objective To compare the effects of intelligent ventilator weaning method and physician-directed-weaning process in children after surgery for congenital heart disease. Methods A to tal of 92 children with acyanotic congenital heart disease hospitalized in the Department of Cardiovascular Surgery of Shenzhen Children＇s Hospital from May 2013 to May 2015 were divided into two groups according to different weaning methods. The observation group（n=50） were treated with intelligent ventilator weaning method, and the control group（n=42） received traditional weaning process based on physician＇s experience. Comparison of two groups were evaluated on change of weaning time,weaning success rate, reset rate, both vital signs taken at 30 minutes befor and after weaning. Results The weaning time for the observation group was （0.59±0.16） d, significantly shorter than（1.04±0.21） d for the control group（P〈0.01）.No statistically significant differences in heart rate, blood pressure, respiration rate were observed between pre-and post-weaning observation group and control group（P〈0.05）; while they had significantly differences in oxygenation index（OI）, partial pressure of carbon dioxide（PaCO2） and p H（P〈0.05）. Patients in observation group had significantly higher weaning success rate than control group（88.0% vs 69.0% , P〈0.01）. Conclusion Intelligent ventilator weaning method can shorten the ventilator assisted time and improve the weaning success rate, so it is worth popularizing.

关 键 词：临床效果 先天性心脏病 机械通气 撤机 

分 类 号：R725.4[医药卫生—儿科]