不同机械通气模式对呼吸机相关性膈肌功能障碍的影响

发布时间：2018-03-01 13:30

  本文关键词： 机械通气模式 呼吸机相关性膈肌功能障碍　出处：《实用医学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的:比较不同机械通气模式对呼吸机相关性膈肌功能障碍(VIDD)的影响。方法:收集笔者所在ICU中接受有创机械通气的下腹部外科术后患者,按通气模式进行分组,并对结果进行分析。再按脱机结果分为2组,以脱机是否成功为因变量,以有统计学意义的临床指标为自变量,用Logistic回归分析对呼吸机撤机的影响。结果:不同通气模式组间比较,A/C模式组的机械通气时间、48 h重新插管率、ICU滞留时间显著高于SIMV模式组和PSV模式组,脱机成功率显著低于SIMV模式组和PSV模式组,差异有统计学意义(P0.05)。脱机成功组的3种通气模式比例和脱机失败组比较,差异有统计学意义(P0.05)。以脱机情况为因变量,以APACHEⅡ评分、ALB、通气模式等3项指标为自变量,采用Logistic回归分析的进入法进行分析。APACHEⅡ评分、通气模式是脱机成功与否的独立影响因素。结论:SIMV模式和PSV模式较A/C模式在下腹部外科术后患者机械通气过程中VIDD影响更小,撤机成功率更高。SIMV模式和PSV模式对撤机影响无明显差异。
[Abstract]:Objective: to compare the effects of different mechanical ventilation modes on VIDD in patients with ventilator associated diaphragmatic dysfunction. Methods: patients undergoing invasive mechanical ventilation after lower abdominal surgery in our ICU were divided into groups according to ventilation mode. The results were analyzed and divided into two groups according to the results of weaning. The success of weaning was regarded as dependent variable and the clinical index with statistical significance as independent variable. Results: the mechanical ventilation time and re-intubation rate of A- / C model group were significantly higher than those of SIMV model group and PSV model group. The success rate of weaning was significantly lower than that of SIMV mode and PSV mode group, and the difference was statistically significant (P 0.05). The proportion of three ventilation modes in the successful weaning group and the failure group were significantly lower than those in the offline failure group. Using APACHE 鈪，

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