超声评估肋间肌和膈肌功能对撤呼吸机的预测价值  

Value of ultrasound evaluation of intercostal muscle and diaphragm functions in predicting ventilator weaning

作　　者：魏祖健 余晓婵 罗醒政 郑梓均 古伟光 WEI Zujian;YU Xiaochan;LUO Xingzheng;ZHENG Zijun;GU Weiguang(Intensive Care Department,Xiaolan People’s Hospital of Zhongshan,Zhongshan 528415,China)

机构地区：[1]中山市小榄人民医院重症医学科,广东中山528415 [2]中山市小榄人民医院新生儿科,广东中山528415

出　　处：《青岛大学学报（医学版）》2024年第5期697-700,共4页Journal of Qingdao University(Medical Sciences)

基　　金：中山市医学科研基金项目(2021A020305)。

摘　　要：目的探讨超声测量膈肌移动度(DE)、膈肌增厚分数(DTF)、肋间肌增厚分数(TFic)对重症病人机械通气成功撤机的预测价值。方法选取2021年6月-2022年9月在我院进行有创机械通气的病人85例,其中撤机成功组病人71例,撤机失败组14例。采用灵敏度、特异度和受试者工作特征(ROC)曲线下面积(AUC)评价DE、DTF、TFic及其联合对重症病人机械通气撤机的预测价值。结果撤机成功组的DE、DTF显著高于撤机失败组(t=4.74、4.76,P<0.05),TFic显著低于撤机失败组(t=3.78,P<0.05)。DE、DTF、TFic三者联合对成功撤呼吸机预测价值较高,其AUC为97.2%,灵敏度为95.8%,特异度为92.9%。结论DE、DTF、TFic三者联合对重症病人撤呼吸机有较大的指导意义。Objective To investigate the value of diaphragmatic excursion(DE),diaphragmatic thickening fraction(DTF),and intercostal muscle thickening fraction(TFic)measured by ultrasound in predicting successful weaning from mechanical ventilation in critically ill patients.Methods A total of 85 patients who underwent invasive mechanical ventilation in our hospital from June 2021 to September 2022 were enrolled,with 71 patients in successful weaning group and 14 patients in failed weaning group.Sensitivity,specificity,and area under the receiver operating characteristic curve(AUC)were used to investigate the value of DE,DTF,TFic,and their combination in predicting successful weaning from mechanical ventilation in critically ill patients.Results Compared with the failed weaning group,the successful weaning group had significantly higher DE and DTF(t=4.74,4.76,P<0.05)and a significantly lower TFic(t=3.78,P<0.05).The combination of DE,DTF,and TFic had a relatively high value in predicting successful ventilator weaning,with an AUC of 97.2%,a sensitivity of 95.8%,and a specificity of 92.9%.Conclusion The combination of DE,DTF,and TFic has good guiding significance for ventilator weaning in critically ill patients.

关 键 词：超声检查 肋间肌 膈 呼吸 人工 通气机撤除法 预测 

分 类 号：R605.973[医药卫生—急诊医学] R445.1[医药卫生—外科学]