摘要
目的通过分析影响呼吸机撤离的相关因素,寻找与呼吸机撤离成败相关的关键性环节,提出针对性的解决措施,为临床撤机实践提供理论指导。方法收集我院近5年来行机械通气治疗140例患者的临床资料,整理归类后进行相应的统计学分析。结果单因素logistic回归分析结果表明:年龄、性别等26项因素对撤机过程有影响。多因素logistic回归分析结果表明:肺部感染、腹胀、APACHEⅡ评分是影响撤机的独立危险性因素,强有力的咳嗽排痰能力是撤机过程的有利因素。从撤机方式来看,SBT撤机方式成功率最高,其次为有创-无创序贯通气,直接撤机方式成功率最低。结论基础疾病的种类和严重程度对患者预后影响很大。肺部感染、腹胀和APACHEⅡ评分是影响撤机成败的独立危险因素,患者自主咳嗽及排痰能力是撤机过程的唯一保护性因素。采用SBT方式撤机,可提高撤机成功率。
Objective To find out the key link influencing weaning results,and to explore the practice guidelines for weaning. Methods The clinical data of 140 patients with mechanical ventilation in our hospital over the last five years were collected and analyzed. Results Univariate logistic regression analysis showed that 26 factors including age,gender and so on influenced weaning results.Multivariate logistic regression analysis showed that pulmonary infection,abdominal distension and APACHEⅡscore were independent risk factors of weaning,while the effective ability of cough and spit was an advantageous factor influencing weaning.In terms of usual weaning ways,the achievement rate of spontaneous breathing trial（SBT）was the highest,followed by the way of sequential non-invasive following short-term invasive mechanical ventilation,while the achievement rate of direct weaning way was the lowest. Conclusion The sort and severity of basic diseases could influence greatly patients＇ prognosis.Pulmonary infection,abdominal distension and APACHEⅡscore are independent risk factors of weaning.Patients＇ autonomous ability to cough and spit is the sole protective factor of weaning.The weaning way SBT can enhance the achievement rate of weaning.
出处
《山西医科大学学报》
CAS
2008年第5期454-457,共4页
Journal of Shanxi Medical University
关键词
呼吸机
撤机
影响因素
ventilator
weaning
influential factor
作者简介
王飞，男，1975—08生，在读硕士，住院医师．
