自主呼吸实验指导下间歇低水平持续气道正压撤机在机械通气患者中的应用效果  

Effect of spontaneous breathing trial guided intermittent continuous positive airway pressure weaning in mechanically ventilated patients

作　　者：刘琴 黄成凯 饶兴发 LIU Qin;HUANG Chengkai;RAO Xingfa(Department of Critical Care Medicine,Qianxinan People's Hospital,Qianxinan,Guizhou 562400,China)

机构地区：[1]黔西南州人民医院重症医学科,贵州黔西南562400

出　　处：《医药前沿》2025年第6期52-54,58,共4页Journal of Frontiers of Medicine

摘　　要：目的分析自主呼吸实验(SBT)指导下间歇低水平持续气道正压撤机在机械通气患者中的应用效果。方法选取2023年8月-2024年2月黔西南州人民医院收治的采用有创机械通气手段进行治疗的患者84例。以脱机方式为依据,按照配对原则,从常规低水平持续气道正压(CPAP)撤机患者中选取42例作为对照组,从间歇CPAP撤机患者中选取42例作为观察组。观察组采用SBT指导下间歇CPAP撤机,即连续3 d的间断CPAP脱机,对照组采用常规CPAP脱机。比较两组患者的脱机成功率及再插管率,比较心率、动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)等常规指标;统计并观察两组患者病死率、呼吸机相关性肺炎(VAP)发生率、医疗费用。结果观察组患者脱机成功率高于对照组,再插管率低于对照组,住院时间、计划撤机后机械通气时间短于对照组,医疗费用少于对照组;脱机时,观察组患者的SaO2、PaO2高于对照组,心率低于对照组,差异有统计学意义(P<0.05)。两组病死率、VAP发生率比较,差异无统计学意义(P>0.05)。结论SBT指导下间歇CPAP撤机在提高脱机成功率、降低再插管率及控制医疗费用方面具有重要的作用。Objective To analyze the effect of spontaneous breathing trial(SBT)guided intermittent continuous positive airway pressure(CPAP)weaning in mechanically ventilated patients.Methods A total of 84 patients treated with invasive mechanical ventilation admitted to Qianxinan People's Hospital from August 2023 to February 2024 were selected.Based on the weaning method and according to the matching principle,42 patients were selected from those with conventional low-level continuous positive airway pressure(CPAP)weaning as the control group,and 42 patients were selected from those with intermittent CPAP weaning as the observation group.The observation group adopted SBT guided intermittent CPAP weaning,that is,intermittent CPAP weaning for 3 consecutive days,and the control group used conventional CPAP weaning.The weaning success rate and reintubation rate of the two groups of patients were compared.Routine indicators such as heart rate,arterial oxygen saturation(SaO2),and arterial partial pressure of oxygen(PaO2)were contrasted.The mortality rate,incidence of ventilator-associated pneumonia(VAP),and medical expenses of the two groups of patients were statistically observed.Results The weaning success rate of the observation group was higher than that of the control group,the reintubation rate was lower than that of the control group,the mechanical ventilation time after planned weaning and hospitalization time were shorter than those of the control group,and medical expenses was less than that of the control group.During weaning,the SaO2 and PaO2 of the observation group were higher than those of the control group,and the heart rate was lower than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the mortality rate and VAP incidence between the two groups(P>0.05).Conclusions The intermittent CPAP weaning guided by SBT plays a very important role in improving the weaning success rate,reducing the reintubation rate,and controlling medical expenses.

关 键 词：自主呼吸实验 机械通气 撤机干预 脱机成功率 再插管率 

分 类 号：R563[医药卫生—呼吸系统]