NT-proBNP联合CVP监测在机械通气患者撤机过程中的指导作用  

The guiding role of NT-proBNP combined with CVP in mechanical ventilation weaning

作　　者：刘杰[1] 王岗[1] 孙师元[1] 

机构地区：[1]西安交通大学第二附属医院急诊科,西安710004

出　　处：《临床急诊杂志》2017年第8期622-624,共3页Journal of Clinical Emergency

摘　　要：目的:探讨N端脑钠素前体(NT-proBNP)水平联合中心静脉压(CVP)监测在机械通气患者撤机过程中的指导作用。方法:回顾性分析2010-11-2012-12我科(ICU)100例行机械通气患者的病例资料。达到撤机条件后,根据自主呼吸试验标准(SBT)逐步进行撤机,根据48h内的撤机结果,分为撤机成功组(76例)和撤机失败组(24例)。比较2组患者入院时和撤机后的NT-proBNP、CVP水平,并比较2组患者撤机前后48h内的液体平衡量和呼吸频率(BR)的变化。结果:入院时,2组NT-proBNP和CVP水平比较差异无统计学意义。撤机后,2组NT-proBNP、CVP水平较入院时明显降低(均P<0.05),撤机成功组NT-proBNP、CVP水平较撤机失败组明显降低(P<0.05)。撤机前后48h液体平衡量比较,撤机成功组呈负平衡,撤机失败组呈正平衡。撤机48h内,撤机成功组BR较撤机失败组改善(P<0.05)。结论:NT-proBNP水平变化联合CVP监测对机械通气患者的撤机有指导作用,一定程度上可以提高撤机成功率。Objective：To discuss the guiding role of NT-proBNP level combined with CVP in mechanical ventilation weaning.Method：Retrospective analysis was performed for 100 patients of mechanical ventilation in our department（ICU）from November 2010 to December 2012.The patients were gradually weaned according to the standard of spontaneous breathing test（SBT）.100 patients were divided into weaning success group（76cases）and weaning failure group（24cases）according to the outcomes of the weaning within 48 hours.The levels of NTproBNP and CVP were compared between the two groups at admission and after weaning,and the changes of fluid balance and breathing rate（BR）were compared within 48 hours before and after weaning.Result：There was no significant difference in the levels of NT-proBNP and CVP between the two groups at admission.The levels of NTproBNP and CVP in the two groups after weaning were significantly lower than those on admission（P〈0.05）,and the level of NT-proBNP and CVP in weaning success group was significantly lower than those in weaning failure group（P〈0.05）.Comparing the fluid balance within 48 hours before and after weaning,the negative balance was found in weaning success groupand the positive balance was found in the weaning failure group.The BR in the weaning success group was significantly improved compared with that in weaning failure group within 48 hours after weaning（P〈0.05）.Conclusion：NT-proBNP level combined with CVP can guide the weaning from mechanical ventilation,and improve the success rate of weaning to a certain extent.

关 键 词：N端脑钠素前体 中心静脉压 液体平衡 机械通气 撤机 

分 类 号：R459.7[医药卫生—急诊医学]