摘要
目的:分析血浆心房利钠肽(ANP)在机械通气患者撤机前后的变化及其临床意义。方法:选取2016年7月-2017年12月无锡市惠山区人民医院行有创-无创序贯机械通气治疗患者96例,检测并记录所有患者自主呼吸试验(SBT)前24 h(T0)、行3 min T管试验前(T1)、撤机后1 h(T2)、撤机后12 h(T3)、撤机后24 h(T4)、撤机后48 h(T5)血浆ANP水平和尿量。根据撤机成功与否将患者分为撤机成功组和撤机失败组,比较两组血浆ANP水平和尿量,并分析血浆ANP与尿量的关系。结果:96例患者T1~T5 ANP与尿量均低于T0(P<0.05),T1~T3 ANP逐渐下降(P<0.05),T1~T4尿量逐渐下降(P<0.05)。撤机失败组撤机前ANP与尿量均高于撤机成功组(P<0.05),撤机后,撤机失败组ANP与尿量低于撤机前,而撤机成功组仅尿量低于撤机前(P<0.05)。撤机前ANP与尿量呈正相关(r=0.567,P<0.05)。结论:血浆ANP在机械通气患者撤机前后发生明显变化,可将血浆ANP作为机械通气患者成功撤机的早期预测指标之一,并依据血浆ANP水平对尿量进行干预,提高机械通气患者撤机成功率。
Objective:To analyze the changes of plasma atrial natriuretic peptide(ANP)during and after mechanical ventilation and the clinical significance.Method:96 patients treated with invasive-noninvasive sequential mechanical ventilation in Wuxi Huishan District People’s Hospital from July 2016 to December 2017 were selected.The plasma ANP levels and urine volume before spontaneous breathing trial(SBT)24 h(T0),before 3 min T tube test(T1),1 h after weaning(T2),12 h after weaning(T3),24 h after weaning(T4)and 48 h after weaning(T5).According to the success of weaning,the patients were divided into the successful weaning group and the failed weaning group,and the plasma ANP level and urine volume were compared between the two groups.The relationship between plasma ANP and urine volume was analyzed.Result:In 96 patients,T1~T5 ANP and urine volume were lower than those at T0(P<0.05),T1~T3 ANP decreased gradually(P<0.05),the urine volume of T1~T4 decreased gradually(P<0.05).ANP and urine volume before weaning in the failed weaning group were higher than those in the successful weaning group(P<0.05),after weaning,ANP and urine volume in the failed weaning group were lower than those of before weaning,while only urine volume in the successful weaning group was lower than that of before weaning(P<0.05).ANP was positively correlated with urine volume before weaning(r=0.567,P<0.05).Conclusion:There are obvious changes of plasma ANP during and after mechanical ventilation,plasma ANP can be used as one early predictor of successful weaning,and according to the level of plasma ANP,the urine volume can be intervened to improve the success rate of weaning.
作者
王开成
张冠军
辛宝琼
WANG Kaicheng;ZHANG Guanjun;XIN Baoqiong(Wuxi Huishan District People’s Hospital,Wuxi 214187,China)
出处
《中国医学创新》
CAS
2019年第24期53-56,共4页
Medical Innovation of China
基金
无锡市科技发展资金项目(CSE31N1619)
关键词
心房利钠肽
机械通气
撤机
Atrial natriuretic peptide
Mechanical ventilation
Weaning
作者简介
通信作者:王开成
