CAJ | 학술논문

目的：分析有创机械通气患者呼吸机依赖的相关危险因素。方法选取2008年1月至2012年6月在我院呼吸内科重症监护室住院的372例有创机械通气患者的临床资料进行分析。结果372例有创机械通气患者中，呼吸机依赖组91例。年龄≥70岁、既往有慢性阻塞性肺疾病（COPD）、心功能≥NYHAⅢ级、脑血管意外并吸入性肺炎、脓毒症休克、合并多器官功能障碍综合征（MODS）、体质量指数＜18.5kg/m2、运动神经元病与呼吸机依赖关系密切。结论对于≥70岁患者，既往有COPD病史患者应尽早脱机，根据病情行有创-无创通气序贯治疗；另外积极改善心功能，加强肺部及全身感染的控制，加强营养支持，预防MODS的发生是减少呼吸机依赖患者的有效措施。
목적：분석유창궤계통기환자호흡궤의뢰적상관위험인소。방법선취2008년1월지2012년6월재아원호흡내과중증감호실주원적372례유창궤계통기환자적림상자료진행분석。결과372례유창궤계통기환자중，호흡궤의뢰조91례。년령≥70세、기왕유만성조새성폐질병（COPD）、심공능≥NYHAⅢ급、뇌혈관의외병흡입성폐염、농독증휴극、합병다기관공능장애종합정（MODS）、체질량지수＜18.5kg/m2、운동신경원병여호흡궤의뢰관계밀절。결론대우≥70세환자，기왕유COPD병사환자응진조탈궤，근거병정행유창-무창통기서관치료；령외적겁개선심공능，가강폐부급전신감염적공제，가강영양지지，예방MODS적발생시감소호흡궤의뢰환자적유효조시。
Objective To analyze the related risk factors of the patients with ventilator dependence. Methods A total of 372 patients with invasive mechanical ventilation admitted in our respiratory intensive care unit of the General Hospital of Shenyang Military Command from January 2008 to June 2012 were enrolled in this study. Their clinical data were collected and analyzed. Results Among the 372 patients, ventilator dependence occurred in 91 patients. The elder age (older than 70 years), history of chronic obstructive pulmonary disease (COPD), low heart function (heart function of NYHA Ⅲ or Ⅳ), cerebral accident and aspiration pneumonia, sepsis shock, multiple organ dysfunction syndrome (MODS), low body mass index (<18.5 kg/m2), and motor neuron disease were the risk factors of ventilator dependence. Conclusion For the patients older than 70 years and having history of COPD, ventilator weaning should be done as early as possible, and sequential invasive ventilation to non-invasive ventilation treatment be carried out according to patient’s condition. What’s more, improving the heart function, strengthening the lungs and general infection control, improving the nutritional support, and preventiing the of MODS are effective measures to reduce ventilator dependence.