膈肌超声参数评估ICU呼吸机依赖患者撤机结局及生存状况的研究  

Study on the Evaluation of Diaphragmatic Ultrasound Parameters for the Withdrawal Outcome and Survival Status of ICU Ventilator-Associated Patients

作　　者：卢志萍 邓兴[1] 李均祥 LU Zhiping;DENG Xing;LI Junxiang(Department of Intensive Care Medicine,Longyan Second Hospital,Longyan,Fujian 364000,China)

机构地区：[1]龙岩市第二医院重症医学科,福建龙岩364000

出　　处：《中国医药指南》2025年第10期40-43,共4页Guide of China Medicine

摘　　要：目的探讨ICU呼吸机依赖患者中使用膈肌超声参数评估其撤机结局、生存状况的应用价值。方法选取2022年12月至2023年12月龙岩市第二医院重症医学科收治的180例呼吸机依赖患者作为研究对象,按照是否成功撤机分为撤机成功组(n=144)和撤机失败组(n=36)。所有患者均接受膈肌超声检查,测量并记录膈肌活动度(DE)、膈肌增厚分数(DTF)、吸气末膈肌厚度(DTei)、呼气末膈肌厚度(DTee)的超声参数。同时,收集患者的一般临床资料。采用SPSS 25.0软件进行数据分析,比较两组患者的膈肌超声参数及临床资料的差异,并采用Logistic多因素回归方程分析膈肌超声参数与患者撤机结局(撤机成功)、生存状况(存活)的关系。结果撤机成功组患者的DE、DTF、DTei、DTee检测水平均高于撤机失败组(均P<0.05)。Logistic回归分析显示,DE、DTF、DTei、DTee是预测撤机结局、生存状况的独立因素(P<0.05)。结论在ICU呼吸机依赖患者中采用膈肌超声参数对其进行评估能有效提高撤机成功率和患者存活率。Objective To explore the application value of using diaphragmatic ultrasound parameters to evaluate the withdrawal outcome and survival status of ICU ventilator-associated patients.Methods A total of 180 ventilators dependent patients admitted to the Department of Intensive Care Medicine of Longyan Second Hospital from December 2022 to December 2023 were selected as the study objects,and were divided into successful group(n=144)and failed group(n=36)according to whether they were successfully withdrawn.All patients underwent diaphragmatic ultrasonography,and the parameters of diaphragmatic motion(DE),diaphragmatic thickening rate(DTF),end-inspiratory diaphragmatic thickness(DTei),and end-respiratory diaphragmatic thickness(DTee)were measured and recorded.At the same time,general clinical data of the patients were collected.SPSS 25.0 software was used for data analysis,and the differences in diaphragm ultrasound parameters and clinical data of the two groups were compared.Logistic multivariate regression equation was used to analyze the relationship between diaphragm ultrasound parameters and the outcome(successful withdrawal)and survival status(survival)of the patients.Results The detection levels of DE,DTF,DTei,and DTee in the successful weaning group were higher than those in the failed weaning group(all P<0.05);Logistic regression analysis showed that DE,DTF,DTei,and DTee were independent factors predicting withdrawal outcomes and survival status(P<0.05).Conclusions Evaluating diaphragmatic ultrasound parameters in ICU ventilator-associated patients can effectively improve the success rate of weaning and patient survival.

关 键 词：膈肌超声 呼吸机依赖 撤机结局 生存状况 重症医学科 

分 类 号：R459.7[医药卫生—急诊医学]