床旁多脏器超声在重症患者机械通气脱机风险评估中的应用价值  

Application Value of Bedside Multi-organ Ultrasound in Risk Assessment of Weaning from Mechanical Ventilation in Critically Ill Patients

作　　者：刘志伟[1] 曾金华[1] 刘琳 卢敏[1] 刁秀平 高坤华[1] Liu Zhi-wei;Zeng Jin-hua;Liu Lin;Lu Min;Diao Xiu-ping;Gao Kun-hua(Department of Internal Medicine,Huangjiang Hospital,Dongguan 523750,Guangdong Province,China)

机构地区：[1]广东省东莞市黄江医院内科,广东东莞523750

出　　处：《中外医药研究》2022年第18期120-122,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：东莞市社会发展科技项目(编号:20211800900712)。

摘　　要：目的:分析床旁多脏器超声在重症患者机械通气脱机风险评估中的临床价值。方法:选取2021年6月—2022年6月广东省东莞市黄江医院内科收治的实施机械通气支持且达到临床撤机标准的重症患者52例为研究对象,根据脱机结果将患者分为脱机成功组40例与脱机失败组12例。撤机前均实施床旁多脏器超声(包括心脏、肺部、膈肌)检查。根据脱机结果将患者分为脱机成功组(n=40)与脱机失败组(n=12)。比较两组患者床旁多脏器组织超声指标。结果:脱机成功组肺部超声评分、肺动脉收缩压、血流流速比值低于脱机失败组,左室射血分数、膈肌活动度、膈肌厚度高于脱机失败组,差异有统计学意义(P=0.000)。结论:在重症机械通气患者的脱机风险评估中实施床旁多脏器超声评估,可预测患者的撤机成功情况,指导机械通气患者撤机。Objective:To analyze the clinical value of bedside multi-organ ultrasound in risk assessment of weaning from mechanical ventilation in critically ill patients.Methods:From June 2021 to June 2022,52 critically ill patients who were admitted to the Department of Internal Medicine of Huangjiang Hospital,Dongguan,Guangdong Province,who received mechanical ventilation support and reached the clinical weaning standard were selected as the research objects.Patients were divided into successful weaning group(n=40)and failed weaning group(n=12)according to weaning results.Bedside multi-organ ultrasound(including heart,lung,and diaphragm)examinations were performed before weaning.According to the weaning results,the patients were divided into weaning success group(n=40)and weaning failure group(n=12).The bedside multiple organ tissue ultrasound indexes were compared between the two groups.Results:The lung ultrasound score,pulmonary artery systolic pressure,and blood flow velocity ratio in the successful weaning group were lower than those in the weaning failure group,and the left ventricular ejection fraction,diaphragm activity,and diaphragm thickness were higher than those in the weaning failure group,and the difference was statistically significant(P=0.000).Conclusion:Bedside multi-organ ultrasound assessment in the weaning risk assessment of critically ill mechanically ventilated patients can predict the success of weaning and guide the weaning of mechanically ventilated patients.

关 键 词：床旁多脏器超声 机械通气 脱机风险 撤机 

分 类 号：R47[医药卫生—护理学]