超声膈肌功能评估在ARDS患者无创机械通气效果预测评估中的价值  

The Value of Ultrasound Diaphragm Function Assessment in Predicting the Effectiveness of Non-Invasive Mechanical Ventilation in ARDS Patients

作　　者：姚国华 刘泉[1] YAO Guo-Hua;LIU Quan(Integrated ICU Areal,Tai'an Central Hospital Affi liated to Qingdao University,Tai'an Shandong 271000,China)

机构地区：[1]青岛大学附属泰安市中心医院综合ICU一区,山东泰安271000

出　　处：《中华养生保健》2025年第7期60-64,共5页CHINESE HEALTH CARE

基　　金：泰安市科技创新发展项目(政策引导类)(2021NS378)。

摘　　要：目的探究急性呼吸窘迫综合征(Acute Respiratory Distress Syndrome,ARDS)患者在进行无创机械通气治疗过程中开展超声膈肌功能评估对患者撤机预测评估的作用。方法回顾性分析2023年3月—2024年3月于青岛大学附属泰安市中心医院进行无创机械通气治疗的120例ARDS患者,患者持续进行48 h治疗,结合患者撤机情况划分为无创机械通气成功组(80例)与无创机械通气失败组(40例)。两组患者治疗期间分别在治疗开始6 h、12 h、24 h、30 h、36 h、42 h、48 h进行检测与对比膈肌活动度和膈肌增厚分数。并针对超声膈肌功能评估的预测价值进行评估。并对比两组呼吸频率、PaO_(2)/FiO_(2)、ICU住院时间以及总住院时间。结果针对两组患者在治疗期间膈肌活动度和膈肌增厚分数统计,差异有统计学意义(P<0.05)。对比两组呼吸频率、PaO_(2)/FiO_(2),两组差异有统计学意义(P<0.05)。对比两组ICU住院时间以及总住院时间,差异有统计学意义(P<0.05)。结合受试者工作特征(ROC)曲线分析,膈肌活动度预测无创机械通气效果ROC曲线下面积为0.872,膈肌活动度>13.0 mm敏感率为80.5%,膈肌增厚分数预测无创机械通气效果ROC曲线下面积为0.845,膈肌增厚分数>36.00%敏感率为81.85%。结论ARDS患者无创机械通气治疗过程中开展超声膈肌功能评估可在一定程度上对患者治疗效果进行预测,可以为临床通气治疗方案制订与完善提供指导。Objective To investigate the role of ultrasound diaphragm function assessment in predicting patient withdrawal during non-invasive mechanical ventilation treatment in patients with acute respiratory distress syndrome(ARDS).Method A retrospective analysis was conducted on 120 patients with ARDS who underwent non-invasive mechanical ventilation treatment in our hospital from March 2023 to March 2024.The patients underwent continuous treatment for 48 hours and were divided into a successful non-invasive mechanical ventilation group(80 cases)and a failed non-invasive mechanical ventilation group(40 cases)based on their weaning status.During the treatment of two groups of patients,diaphragm activity and diaphragm thickening score were measured and compared at 6 h,12 h,24 h,30 h,36 h,42 h,and 48 h respectively.And evaluate the predictive value of ultrasound diaphragm function assessment.And compare the respiratory rate,PaO_(2)/FiO_(2),ICU hospitalization time,and total hospitalization time between the two groups.Result The diff erence in diaphragm activity and diaphragm thickening score between the two groups of patients during treatment was statistically signifi cant(P<0.05).There was a significant difference in respiratory rate and PaO_(2)/FiO_(2)between the two groups(P<0.05).The difference in ICU hospitalization time and total hospitalization time(P<0.05)is statistically signifi cant.Based on the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve for predicting non-invasive mechanical ventilation eff ectiveness using diaphragmatic activity is 0.872,with a sensitivity rate of 80.5%for diaphragmatic activity>13.0 mm.The area under the ROC curve for predicting non-invasive mechanical ventilation eff ectiveness using diaphragmatic thickening score is 0.845,and the sensitivity rate for diaphragmatic thickening score>36.00%is 81.85%.Conclusion Conducting ultrasound diaphragmatic function assessment during non-invasive mechanical ventilation treatment for ARDS patients can predict the treatm

关 键 词：超声膈肌功能评估 ARDS患者 无创机械通气效果 预测评估 

分 类 号：R563.8[医药卫生—呼吸系统]