摘要
目的:探讨床旁超声联合镇静躁动评分(RASS评分)指导下拔管对呼吸系统加强监护病房(RICU)机械通气患者撤机成功率和不良事件发生的影响。方法:回顾性分析2020年1月—2022年1月在荆州市第三人民医院治疗的80例RICU机械通气患者的临床资料,根据拔管方式的不同将患者分为常规组(n=35)和联合组(n=45)。常规组采用常规方法指导拔管,联合组采用床旁超声联合RASS评分指导下拔管。比较两组撤机成功率、不良事件发生率、撤机成功患者机械通气时间和机械通气24 h后和撤机2 h后两组的心率(HR)、中心静脉压(CVP)、呼吸频率(RR)、平均动脉压(MAP)变化。结果:联合组撤机成功率为93.33%,高于常规组的71.43%,差异有统计学意义(P<0.05);联合组撤机成功患者机械通气时间短于常规组,差异有统计学意义(P<0.05)。联合组不良事件发生率为8.89%,低于常规组的40.00%,差异有统计学意义(P<0.05)。机械通气24 h后,两组HR、CVP、RR、MAP指标比较,差异无统计学意义(P>0.05);撤机2 h后,两组HR、CVP、RR、MAP指标均高于机械通气24 h后,且联合组HR、CVP、RR、MAP指标均低于常规组,差异有统计学意义(P<0.05)。结论:床旁超声联合RASS评分指导下拔管可以提升RICU机械通气患者撤机成功率,且降低不良事件发生率,避免患者的生命体征出现大幅度的变化。
Objective:To explore the extubation guided by bedside ultrasound combined with richmond agitation and sedation scale score(RASS score)on the success rate of extubation and adverse events in patients with mechanical ventilation in the respiratory intensive care unit(RICU).Method:The clinical data of 80 patients treated in RICU mechanical ventilation in the Third People's Hospital of Jingzhou from January 2020 to January 2022 were retrospectively analyzed.According to different extubation methods,the patients were divided into conventional group(n=35)and combined group(n=45).The conventional group used conventional methods to guide extubation,and the combined group used bedside ultrasound combined with RASS score to guide extubation.The successful rate of withdrawal,the incidence of adverse events,mechanical ventilation time of successful withdrawal,and the changes of heart rate(HR),central venous pressure(CVP),respiratory rate(RR)and mean arterial pressure(MAP)after mechanical ventilation for 24 h and 2 h after withdrawal were compared between the two groups.Result:The success rate of extubation of the combined group was 93.33%,which was higher than 71.43%of the conventional group,and the difference was statistically significant(P<0.05).The mechanical ventilation time of successful withdrawal of combined group was shorter than that of conventional group,and the difference was statistically significant(P<0.05).The incidence of adverse events in combined group was 8.89%,which was lower than 40.00%in conventional group,and the difference was statistically significant(P<0.05).After mechanical ventilation for 24 h,there were no significant differences in HR,CVP,RR and MAP indexes between the two groups(P>0.05).At 2 h after withdrawal,the HR,CVP,RR,and MAP indicators in both groups were higher than those after mechanical ventilation for 24 h,and the HR,CVP,RR,and MAP indicators in the combined group were lower than those in the conventional group,the differences were statistically significant(P<0.05).Conclusion:Extubati
作者
肖卫兵
张小燕
XIAO Weibing;ZHANG Xiaoyan(The Third People's Hospital of Jingzhou,Jingzhou 434000,China)
出处
《中外医学研究》
2023年第31期135-138,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
床旁超声
机械通气
不良事件
Bedside ultrasound
Mechanical ventilation
Adverse event
