【摘要】 目的研究浅快呼吸指数(f/VT)和呼吸功(WOB)对机械通气患者撤机的指导作用。方法选择机械通气并准备撤机23例慢性阻塞性肺部疾病患者,应用BICORE-CP100呼吸监测仪床边监测病人f/VT、WOB、潮气量(VT)、呼吸频率(RR)、每分钟通气量(MV)、最大吸气压(MIP)、氧合指数(PaO2/FiO2)及APACHⅡ评分,并将浅快呼吸指数、呼吸功值和常规撤机指标及APACHⅡ评分相互比较,观察其对撤机的指导意义。结果撤机成功16例,其中14例f/VT值≤100 bpm/L,2例f/VT值>100 bpm/L;12例WOB值<0.75 J/L,4例WOB在0.93-1.37 J/L之间。撤机失败7例中,1例f/VT值≤100 bpm/L,6例f/VT值>100 bpm/L;7例WOB>(1.86±0.51)J/L。撤机组f/VT、WOB于成功组相互比较有显著差异(P<0.05)。结论f/VT、WOB对撤机都有重要指导作用,但并非敏感指标,应考虑肺部基础疾病,结合临床综合指标更为可靠。更多还原

【Abstract】 Objective To evaluate the rapidshallow-breathing index（RVR or f/VT） and work of breathing（WOB） as predictive parameters of weaning in patients with mechanical ventilation. Methods f/VT,WOB,standard weaning criteria（respiratory rate,tidal volume,ventilation volume per minute,maximal inspiratory pressure,arterial partial pressure of oxygen/fractional concentration of O₂ in inspired gas） and APACHⅡscore were observed and compared between the succeed and the failed.Results The weaning in 16 cases succeed.Of them,f/VT≤100 bpm/L was in 14 case,f/VT>100 bpm/L was in 6 cases;WOB≤0.75 J/L was in 12 cases,0.93-1.37 J/L in 4 cases.The weaning in 7 cases failed.Of them,f/VT≤100 bpm/L was in 1 case;WOB>（1.86±0.51）J/L was in 7 cases.f/VT、WOB were statistically significantly different（0.01<P<0.05） between the succeed and the failed. Conclusion The results suggest that f/VT and WOB are important to make a decision of weaning,but they are not sensitive indexes.If combined with the relevant clinical signs and basic pulmonary conditions,it will be better to indicate the weaning.更多还原