CAJ | 학술논문

目的:探讨自主呼吸试验(SBT)对机械通气的慢性阻塞性肺病(COPD)患者脱离呼吸机、拔出气管插管时间的影响.方法:采用规范的SBT方法拔出气管插管的COPD患者26例(男性19例,女性7例)列入本研究,作为SBT组.回顾性分析未采用SBT方法拔出气管插管的机械通气COPD患者28例(男性24例,女性4例),作为No-SBT组.比较两组患者机械通气时间、拔出气管插管时间(拔管时间),拔管后气管插管复插率(拔出气管插管48h内)心及PaO_2,PaCO_2血清白蛋白,血红蛋白.结果:两组患者的年龄(P=0.683)、机械通气时间(P=0.167)差异无显著性,但是SBT组拔出气管插管的时间(60min)与No-SBT组(40-540min)比较差异有显著意义(P=0.0001).SBT组和No-SBT组患者拔出气管插管后,需无创通气辅助的患者均为3例(P=0.717),48h内再次气管插管患者前者为2例(2/24),后者为3例(3/28)(P=0.900),再次气管插管的原因均为气道分泌物排出不畅.结论:对COPD患者,在撤离呼吸机、拔出气管插管的过程中采用规范SBT方法可以明显地缩短拔管时间,而且未增加气管插管的复插率.
목적:탐토자주호흡시험(SBT)대궤계통기적만성조새성폐병(COPD)환자탈리호흡궤、발출기관삽관시간적영향.방법:채용규범적SBT방법발출기관삽관적COPD환자26례(남성19례,녀성7례)렬입본연구,작위SBT조.회고성분석미채용SBT방법발출기관삽관적궤계통기COPD환자28례(남성24례,녀성4례),작위No-SBT조.비교량조환자궤계통기시간、발출기관삽관시간(발관시간),발관후기관삽관복삽솔(발출기관삽관48h내)심급PaO_2,PaCO_2혈청백단백,혈홍단백.결과:량조환자적년령(P=0.683)、궤계통기시간(P=0.167)차이무현저성,단시SBT조발출기관삽관적시간(60min)여No-SBT조(40-540min)비교차이유현저의의(P=0.0001).SBT조화No-SBT조환자발출기관삽관후,수무창통기보조적환자균위3례(P=0.717),48h내재차기관삽관환자전자위2례(2/24),후자위3례(3/28)(P=0.900),재차기관삽관적원인균위기도분비물배출불창.결론:대COPD환자,재철리호흡궤、발출기관삽관적과정중채용규범SBT방법가이명현지축단발관시간,이차미증가기관삽관적복삽솔.
Objective:To study the effects of spontaneous breathing trial (SBT) in the discontinuing period in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Method: Twenty-six COPD patients with protocol-driven extubation strategy with SBT as SBT group (male 19, female 7) were included in the study. Twenty-eight COPD patients (male 24, female 4) without SBT as No-SBT group were retrospected. Duration of mechanical ventilation, reintubation rate (48h after extubation), duration of extubation, PaO_2, PaCO_2, levels of blood albumin and hemoglobin were compared between the two groups. Result: All the patients in the two groups were similar in age (P=0.683) and mechanical ventilation duration (P=0.167). However, the extubation duration in SBT group (60 min) was significantly different from that (40-540min) in No-SBT group (P=0.0001). In SBT group, 2 patients who failed within 1-hr SBT were excluded from the study. In each group, there were 3 patients required noninvasive ventilation following extubation (P=0.717). Two (2/24) patients in SBT group and 3 (3/28) patients in No-SBT group needed reintubation (P=0.900). Conclusion: The protocol-driven spontaneous breathing trial may shorten the extubation duration in mechanically ventilated COPD patients. Meanwhile, the rate of reintubation does not increased.