【摘要】 目的分析超声检测膈肌变异率在重症机械通气患者撤机中的应用价值。方法选择在我院进行重症机械通气治疗的82例患者,全部患者经撤机筛查实验后用呼吸机软件检测0.1 s气道闭合压,同时计算患者浅快呼吸指数,随后在呼吸机压力支持模式下或采取持续正压通气方式实施自主呼吸试验,并在自主呼吸试验1 h内使用床旁超声技术检测患者膈肌变异率。依据患者是否撤机成功将其分为成功组和失败组,比较两组体质指数、APACHEⅡ评分、呼吸频率、膈肌变异率及浅快呼吸指数。结果 82例患者中,56例撤机成功,26例撤机失败。失败组体质指数、APACHEⅡ评分均高于成功组(P<0.05)。失败组呼吸频率、浅快呼吸指数高于成功组,膈肌变异率低于成功组(P<0.05)。结论超声检测膈肌变异率可协助医师合理选择撤机时间,有效提升重症机械通气患者的撤机成功率,具有一定应用价值。更多还原

【Abstract】 Objective To analyze the application value of diaphragmatic variability rate detected by ultrasound in ventilator weaning of patients with severe mechanical ventilation. Methods Eighty-two patients treated with severe mechanical ventilation in our hospital were selected. After ventilator weaning screening test, all patients were tested with ventilator software for 0.1 s airway closed pressure, and the rapid shallow breathing index was calculated. Then, the spontaneous breathing trail was carried out under the ventilator pressure support mode or continuous positive pressure ventilation mode, and the diaphragmatic variability rate was detected by bedside ultrasound technology within 1 h of the spontaneous breathing trail. The patients were divided into success group and failure group according to whether ventilator weaning was successful or not. Body mass index, APACHE Ⅱ score, respiratory rate, diaphragmatic variability rate and rapid shallow breathing index were compared between the two groups. Results Among 82 patients, 56 patients were successfully weaned and 26 patients failed. The body mass index and APACHE Ⅱ score of the failure group were higher than those of the success group(P <0.05). The respiratory rate and rapid shallow breathing index of the failure group were higher than those of the success group, and the diaphragmatic variability rate was lower than that of the success group(P <0.05). Conclusion Diaphragmatic variability rate detected by ultrasound can help doctors to choose reasonable ventilator weaning time, effectively improve the ventilator weaning success rate of patients with severe mechanical ventilation, and has certain application value.更多还原