膈肌超声在慢性阻塞性肺病合并呼吸衰竭机械通气患者撤机结果预测中的价值  

The Value of Diaphragm Ultrasound in Predicting the Outcome of Weaning in Patients with Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure and Mechanical Ventilation

作　　者：蒋伟光 吴衡[1] JIANG Weiguang;WU Heng(Emergency Department,Yixing People's Hospital,Yixing,Jiangsu Province,214200 China)

机构地区：[1]宜兴市人民医院急诊科,江苏宜兴214200

出　　处：《中外医疗》2021年第29期22-25,共4页China & Foreign Medical Treatment

基　　金：超声监测下腔静脉变异度和骨骼肌相关参数变化预测机械通气患者撤机结局的研究(M202056)。

摘　　要：目的研究分析膈肌超声在慢性阻塞性肺病合并呼吸衰竭机械通气患者撤机结果预测中的价值。方法便利选取2018年1月—2020年12月在该院接受机械通气治疗的慢性阻塞性肺病合并呼吸衰竭患者(60例)为研究对象,根据撤机是否成功分为失败组(n=30)与成功组(n=30)。两组患者均给予膈肌超声检查,以患者心率(HR)、呼吸频率(RR)、收缩压(SBP)、平均动脉压(MAP)、血氧饱和度(SpO_(2))、机械通气时间、住院时间、血气分析、膈肌超声指标为观察指标,并统计对比两组观察结果。结果在HR、RR、SBP、MAP、SpO_(2)方面,两组对比差异无统计学意义(P>0.05);在机械通气时间、住院时间方面,成功组短于失败组,差异有统计学意义(P<0.05)。在血气分析方面,两组血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))比较差异无统计学意义(P>0.05);成功组酸碱度(pH)、二氧化碳分压(PaCO_(2))分别为(7.40±0.17)、(62.58±4.62)mmHg,与对照组比较,差异有统计学意义(t=6.765、3.881,P<0.05)。在膈肌超声指标方面,两组吸气时间(TI)对比差异无统计学意义(P>0.05);成功组膈肌活动度(DE)、膈肌增厚分数(DTF)、膈肌移动时间(E-T)指数分别为(20.21±2.25)mm、(24.12±3.29)%、(2.22±0.30),与对照组比较差异有统计学意义(t=4.904、5.877、8.376,P<0.05)。结论在慢性阻塞性肺病合并呼吸衰竭机械通气患者治疗中,通过膈肌超声检查,有助于预测患者撤机结果,值得临床推荐应用。Objective To study and analyze the value of diaphragm ultrasound in predicting the results of weaning in patients with chronic obstructive pulmonary disease and mechanical ventilation with respiratory failure.Methods From January 2018 to December 2020,Patients with chronic obstructive pulmonary disease combined with respiratory failure(60 cases)who received mechanical ventilation in the hospital were selected conveniently as the research object.According to whether the weaning was successful or not,they were divided into failure group(n=30)and success group(n=30).Both groups of patients were given ultrasound examination of the diaphragm.The patient’s heart rate(HR),respiratory rate(RR),systolic blood pressure(SBP),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),mechanical ventilation time,hospital stay,blood gas analysis and ultrasound indexes of diaphragm were the observation indexes,and the observation results of the two groups were statistically compared.Results In terms of HR,RR,SBP,MAP,SpO_(2),there was no statistically significant difference between the two groups(P>0.05);in terms of mechanical ventilation time and hospital stay,the successful group was shorter than the failure group,and the difference was statistically significant(P<0.05).In blood gas analysis,there was no significant difference in blood oxygen partial pressure(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))between the two groups(P>0.05);the successful group's pH(pH)and carbon dioxide partial pressure(PaCO_(2))were respectively(7.40±0.17)and(62.58±4.62)mmHg,compared with the control group,the difference was statistically significant(t=6.765,3.881,P<0.05).In terms of diaphragm ultrasound indexes,there was no significant difference in inspiratory time(TI)between the two groups(P>0.05);the success group’s diaphragm activity(DE),diaphragm thickening fraction(DTF),and diaphragm movement time(ET)indexes were(20.21±2.25)mm,(24.12±3.29)%,(2.22±0.30),respectively,and the difference was statistically significant compared with th

关 键 词：慢性阻塞性肺病 呼吸衰竭 机械通气 膈肌超声 撤机 

分 类 号：R445[医药卫生—影像医学与核医学]