摘要
目的探讨自主呼吸试验联合无创机械通气在撤离有创通气中的可行性,寻找最佳的撤机方式。方法选择2008年1月至2012年11月秦皇岛市第二医院收治的有创机械通气需要撤机的患者100例,在排除无创机械通气禁忌证的情况下,随机分成两组,各50例,对照组采用自主呼吸试验中的低水平压力支持通气(PSV)(2 h)直接撤机;试验组采用低水平PSV(30 min)法,撤机后给予无创机械通气。比较两组有创机械通气时间、呼吸机相关性肺炎(VAP)的发生率、住院时间、医疗费用及再插管率。结果试验组患者的有创机械通气时间、住院时间、医疗费用少于对照组,VAP的发生率、再插管率均低于对照组(均P<0.05)。结论自主呼吸试验低水平PSV(30 min)联合无创机械通气能尽早撤机,减少有创通气的并发症。
Objective To investigate the feasibility of clinical application of spontaneous breathing trial joint non-invasive ventilation in weaning of invasive ventilation,finding the best weaning manner.Methods 100 patients needing invasive mechanical ventilation weaning,which were without non-invasive mechanical ventilation contraindication,in Qinhuangdao City Second Hospital from January 2008 to November 2012 were randomly divided into two groups,50 cases each;direct weaning afterlow levels of PSV（2 h）method in spontaneous breathing trial was conducted in the control group,while non-invasive mechanical ventilation after stop of the low level of PSV（30 min）method was conducted in the trial group.The occurrence of invasive mechanical ventilation,ventilator-associated pneumonia（VAP）rate,hospitalization time,medical expenses and reintubation rate were compared respectively between the two groups.Results The time of invasive mechanical ventilation,VAP incidence,hospitalization time,medical expenses,and reintubation rate were significantly different respectively between the two groups（P0.05）.Conclusion The low level of spontaneous breathing trial PSV（30 min）combined with noninvasive mechanical ventilation can shorten the time of PSV weaning and reduce the complications of invasive mechanical ventilation.
出处
《医学综述》
2012年第24期4281-4282,共2页
Medical Recapitulate
关键词
自主呼吸试验
机械通气
撤机
Spontaneous breathing trial
Mechanical ventilation
Weaning
