临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
5期
506-508,509
,共4页
张震%贾士强%彭占仙%宗围%文诗伟%孙鲁华%戎雪冰%王竞军%董士民
張震%賈士彊%彭佔仙%宗圍%文詩偉%孫魯華%戎雪冰%王競軍%董士民
장진%가사강%팽점선%종위%문시위%손로화%융설빙%왕경군%동사민
肺疾病,慢性阻塞性%通气机,机械%通气机撤除法%浅快呼吸指数
肺疾病,慢性阻塞性%通氣機,機械%通氣機撤除法%淺快呼吸指數
폐질병,만성조새성%통기궤,궤계%통기궤철제법%천쾌호흡지수
pulmonary disease,chronic obstructive%ventilators,mechanical%ventilator weaning%mechanical ventilation%rapid shallow breathing index
目的：研究睡眠状态下的浅快呼吸指数(RSBI)对慢性阻塞性肺疾病急性加重期(AECOPD)患者撤机的临床意义,探讨用排除精神因素干扰后的浅快呼吸指数指导撤机的时机。方法符合 AECOPD 机械通气指南建议撤机的患者随机分为试验组和常规组,计算不同意识状态下的 RSBI,均以<105 bpm/L 作为标准,分别予以评估撤机时机,常规组以清醒状态下测定的 RSBI 作为撤机预测指标,试验组以睡眠状态下的 RSBI 作为撤机预测指标,评估机械通气时间及撤机成功率。结果常规组与试验组在机械通气时间上分别为(9.24±3.02)天和(7.78±1.97)天,差异有统计学意义(P <0.05),撤机成功率分别达到78.7%和81.4%,差异无统计学意义(P >0.05)。结论睡眠状态下测定的 RSBI 能够避免了意识状态对撤机指标的影响,更早预测撤机时机,有效的缩短有创机械通气时间。
目的：研究睡眠狀態下的淺快呼吸指數(RSBI)對慢性阻塞性肺疾病急性加重期(AECOPD)患者撤機的臨床意義,探討用排除精神因素榦擾後的淺快呼吸指數指導撤機的時機。方法符閤 AECOPD 機械通氣指南建議撤機的患者隨機分為試驗組和常規組,計算不同意識狀態下的 RSBI,均以<105 bpm/L 作為標準,分彆予以評估撤機時機,常規組以清醒狀態下測定的 RSBI 作為撤機預測指標,試驗組以睡眠狀態下的 RSBI 作為撤機預測指標,評估機械通氣時間及撤機成功率。結果常規組與試驗組在機械通氣時間上分彆為(9.24±3.02)天和(7.78±1.97)天,差異有統計學意義(P <0.05),撤機成功率分彆達到78.7%和81.4%,差異無統計學意義(P >0.05)。結論睡眠狀態下測定的 RSBI 能夠避免瞭意識狀態對撤機指標的影響,更早預測撤機時機,有效的縮短有創機械通氣時間。
목적：연구수면상태하적천쾌호흡지수(RSBI)대만성조새성폐질병급성가중기(AECOPD)환자철궤적림상의의,탐토용배제정신인소간우후적천쾌호흡지수지도철궤적시궤。방법부합 AECOPD 궤계통기지남건의철궤적환자수궤분위시험조화상규조,계산불동의식상태하적 RSBI,균이<105 bpm/L 작위표준,분별여이평고철궤시궤,상규조이청성상태하측정적 RSBI 작위철궤예측지표,시험조이수면상태하적 RSBI 작위철궤예측지표,평고궤계통기시간급철궤성공솔。결과상규조여시험조재궤계통기시간상분별위(9.24±3.02)천화(7.78±1.97)천,차이유통계학의의(P <0.05),철궤성공솔분별체도78.7%화81.4%,차이무통계학의의(P >0.05)。결론수면상태하측정적 RSBI 능구피면료의식상태대철궤지표적영향,경조예측철궤시궤,유효적축단유창궤계통기시간。
Objective To assess the clinical value of rapid shallow breathing index (RSBI) in predicting ventilator weaning in sleeping patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD)and to explore the optimal weaning time excluding mental interference.Methods A total of 60 mechanically ventilated patients with AECOPD admitting to ICU in Baoding No.1 Hospital were enrolled in this study.All patients with AECOPD who met ACCP guideline for mechanical ventilation and weaning were divided into conventional group and experimental group.In conventional group,physiological parameters and RSBI were recorded and calculated in the waking state,while in experimental group,physiological parameters and RSBI were recorded and calculated in the sleeping state.Comparison was performed in the success rates of ventilator weaning and duration of ventilation between groups.Results Duration of ventilation was significantly longer in conventional group than in experimental group ([9.24±3.02]days and [7.78 ± 1.97]days,repectively,P <0.05 ).The success rate of ventilator weaning did not show significant difference between two groups (78.7% and 81.4%,repectively,P >0.05 ).Conclusion RSBI can prevent mental interference from influencing ventilator weaning indicator in sleeping patients with COPD and,it can also predict weaning time earlier and shorten effectively mechanical ventilation time.
