肺部超声膈肌运动指标对脓毒症休克患者呼吸机撤离的指导作用  

Guiding Role of Pulmonary Ultrasound Diaphragm Movement Indicators on Ventilator Weaning in Septic Shock Patients

作　　者：马育红[1] 梁亚宁 杨东 王颖 Ma Yuhong;Liang Yaning;Yang Dong;Wang Ying(Emergency Department,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,Ningxia Hui Autonomous Region,China)

机构地区：[1]宁夏回族自治区人民医院急诊科,宁夏回族自治区银川750002

出　　处：《中国社区医师》2024年第36期95-97,共3页Chinese Community Doctors

摘　　要：目的:分析肺部超声膈肌运动指标对脓毒症休克患者呼吸机撤离的指导作用。方法:选取2022年1月—2024年1月宁夏回族自治区人民医院收治的70例脓毒症休克患者作为研究对象,按照呼吸机撤离情况分为撤机失败组和撤机成功组(机械通气治疗72h成功撤机为撤机成功),各35例。患者均进行膈肌超声检查,对比两组住院时间、机械通气时间、病死率、膈肌位移、浅快呼吸指数(RSBI)、膈肌浅快呼吸指数(D-RSBI)。结果:撤机失败组住院时间、机械通气时间长于撤机成功组,病死率高于撤机成功组(P<0.05)。撤机失败组膈肌位移短于撤机成功组,RSBI、D-RSBI高于撤机成功组(P<0.001)。膈肌位移、RSBI、D-RSBI预测撤机失败的效能均较高,其中膈肌位移的预测效能最高(P<0.001)。结论:膈肌位移、RSBI、D-RSBI预测撤机失败的效能较高,其中膈肌位移的预测效能最高,可用于指导脓毒症休克患者呼吸机撤离。Objective:To analyze the guiding role of pulmonary ultrasound diaphragm movement indicators on ventilator weaning in septic shock patients.Methods:A total of 70 patients with septic shock who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2022 to January 2024 were selected as the study subjects.Patients were divided into a weaning failure group and a weaning success group(successful weaning after 72 h of mechanical ventilation treatment was considered a weaning success)according to the status of ventilator weaning,with 35 cases in each group.All patients underwent diaphragmatic ultrasound examination.Length of hospital stay,duration of mechanical ventilation,case fatality rate,diaphragm displacement,rapid shallow breathing index(RSBI),diaphragmatic rapid shallow breathing index(D-RSBI)were compared between two groups.Results:The length of hospital stay and duration of mechanical ventilation in the weaning failure group were longer than those in the weaning success group,and the case fatality rate in the weaning failure group was higher than that in the weaning success group(P<0.05).The diaphragm displacement in the weaning failure group was shorter than that in the weaning success group,and the RSBI and D-RSBI in the weaning failure group were higher than those in the weaning success group(P<0.001).Diaphragm displacement,RSBI and D-RSBI had higher predictive efficacy for weaning failure,and diaphragm displacement had the highest predictive efficacy(P<0.001).Conclusion:Diaphragm displacement,RSBI and D-RSBI have higher predictive efficacy for weaning failure,and diaphragm displacement has the highest predictive efficacy,which can be used to guide ventilator weaning in septic shock patients.

关 键 词：肺部超声 膈肌运动 脓毒症休克 呼吸机撤离 膈肌位移 

分 类 号：R459.7[医药卫生—急诊医学]