摘要
目的比较不同撤机指标对COPD患者撤机的预测价值。方法选取机械通气48h以上且已达到撤机标准的17例COPD患者，采用T型管方法进行自主呼吸试验2h，在自主呼吸试验进行30min时检测气道闭合压（P0.1）、最大吸气压（Pimax）和呼吸浅快指数（RSBI）值，探讨它们在预测COPD患者撤机中的价值。结果lO例COPD患者撤机成功，7例失败。成功组患者的P0.1，和RSBI值明显小于失败组，而Pimax值则明显大于失败组，其差异均具有显著统计学意义（P〈0．05）。P。预测COPD患者撤机的价值明显优于Pimax和RSBI，其灵敏度、特异性和准确性均高于Pimax和RSBI，它们分别为89％、75％和82％。结论P0．1、Pimax和RSBI对COPD患者的撤机均具有指导意义，其中P0．1的价值最大。
Objective To compare the predictive effect of different index on chronic obstructive pulmonary disease （COPD） patients in weaning process. Methods Seventeen patients with COPD after mechanical ventilation for at least 48 hours who were ready for weaning were enrolled. All patient accepted 2 hours spontaneous breathing trial under the T piece. The airway occlusion pressure （P0.1）, maximal inspiratory pressure （Pimax） and rapid shallow breathing index （RSBI） were detected at 30 minutes after spontaneous breathing trial. The clinical value of P0.1 , Pimax and RSBI index for prognosis of successful weaning from COPD patients were assessed. Results Ten patients were successfully weaned from ventilation,and seven patients were difficulty weaned from ventilation. Po. 1 and RSBI in weaning success group were lower than those in weaning failure group （ P 〈0.05）. Pimax in weaning success group was higher than that in weaning failure group （ P 〈0.05）. P0.1 was superior to RSBI and Pimax in predicting weaning outcomes from COPD patients, which sensitivity was 89%, the specificity was 75%, and the accuracy was 82%. They were higher than those of Pimax and RSBI. Conclusions The RSBI, P0.1 and Pimax are valuable predictor for the patients with COPD to wean from mechanical ventilation, and the predicting value of P0.1 is the biggest.
出处
《国际呼吸杂志》
2014年第21期1632-1635,共4页
International Journal of Respiration
关键词
自主呼吸试验
气道闭合压
最大吸气压
呼吸浅快指数
Spontaneous breathing trial
Airway occlusion pressure
Maximal inspiratory pressure
Rapid shallow breathing index
