摘要
目的:探讨膈肌超声在呼吸衰竭机械通气患者脱机评估中的临床应用。方法:选取医院收治的80例呼吸衰竭机械通气患者作为研究对象,根据是否成功脱机分组,脱机成功组51例,脱机失败组29例。比较两组机械通气脱机时相关参数。结果:脱机成功组通气时间、ICU留治时间、PaCO_(2)、潮气量、总住院时间均优于脱机失败组(P<0.05)。脱机成功组浅快呼吸指数低于脱机失败组,左侧膈肌移动度、右侧隔肌移动度及双侧膈肌平均移动度均小于脱机失败组(P<0.05)。当临界值浅快呼吸指数为50.37次/min·L^(-1)、左侧隔肌移动度为9.8mm、右侧隔肌移动度为12.6mm、双侧隔肌平均移动度为13.8mm,其准确率分别为72.10%、71.84%、82.36%、87.61%,约登指数分别为0.464、0.414、0.430、0.592;敏感性分别为62.10%、55.20%、72.40%、85.62%,曲线下面积分别为0.714、0.707、0.736、0.835,双侧隔肌平均移动度预测价值较高,双侧隔肌平均移动度预测价值较高。结论:隔肌超声可有效预测呼吸衰竭机械通气患者脱机结果,其中双侧膈肌平均移动度预测效果更好。
Objective:To explore the clinical application of diaphragmatic ultrasound in off-line evaluation of patients with Respiratory failure undergoing mechanical ventilation.Methods:80 patients with Respiratory failure who received mechanical ventilation in Yudu County People's Hospital were selected as the study subjects.According to whether they were successfully weaned,51 patients were successfully weaned and 29 patients were failed to wean.Obtain two sets of basic data and compare the relevant parameters of mechanical ventilation offline between the two groups.Results:The successful offline group had better ventilation time,ICU stay time,PaCO_(2),tidal volume,and total hospital stay than the failed offline group(P<0.05).The shallow fast breathing index of the successful weaning group was lower than that of the failed weaning group,and the left diaphragm movement,right diaphragm movement,and average bilateral diaphragm movement were all lower than those of the failed weaning group(P<0.05).When the critical value of shallow fast breathing index is 50.37 breaths/min/L,the left diaphragm movement is 9.8 mm,the right diaphragm movement is 12.6 mm,and the average bilateral diaphragm movement is 13.8mm,the accuracy is 72.10%,71.84%,82.36%,87.61%,and the Jordan index is 0.464,0.414,0.430,and 0.592,respectively;The sensitivity was 62.10%,55.20%,72.40%,and 85.62%,respectively.The area under the curve was 0.714,0.707,0.736,and 0.835,respectively.The predictive value of average movement of bilateral diaphragms was high,and the predictive value of average movement of bilateral diaphragms was high.Conclusion:Diaphragm ultrasound can effectively predict the outcome of weaning in patients with Respiratory failure undergoing mechanical ventilation,and the average bilateral diaphragm mobility is better.
作者
胡月鹏
田秋红
戴华
HU Yue-peng;TIAN Qiu-hong;DAI Hua(Yudu County People's Hospital,Yudu 342300,Jiangxi)
出处
《安徽医专学报》
2023年第6期61-63,共3页
Journal of Anhui Medical College
基金
赣州市指导性科技计划项目(编号:20222ZDX8844)。
关键词
膈肌超声
呼吸衰竭
机械通气
脱机
diaphragmatic ultrasound
respiratory failure
mechanical ventilation
offline
