自主呼吸试验安全性筛查宽松标准在ICU撤机中应用效用及安全性研究

发布时间：2018-03-11 18:40

本文选题：机械通气　切入点：撤机　出处：《中国实用内科杂志》2014年05期 　论文类型：期刊论文

【摘要】：目的评估自主呼吸试验(SBT)安全性筛查宽松标准在重症监护病房(ICU)撤机中应用的效用及其安全性。方法选取2010年12月至2011年5月入住浙江省中医院ICU的82例需行有创机械通气的患者,采用随机双盲对照的方法分为SBT安全性筛查宽松标准组(宽松标准组)42例和SBT安全性筛查传统标准组(传统标准组)40例。筛选后行SBT。试验通过则书面通知管床医生SBT安全性筛查标准结果,由管床医生决定何时撤机拔管。比较两组间的脱机状态维持时间、机械通气时间、ICU住院时间、28 d病死率、意外拔管和再插管率。结果宽松标准组较传统标准组脱机状态维持时间更长(25 d对21 d,P=0.000),机械通气时间缩短(3 d对7.5 d,P=0.000),ICU住院时间缩短(11 d对17 d,P=0.001),28 d病死率更低(14.3%对35.0%,P=0.029),意外拔管率(2.4%对7.5%,P=0.574)、再插管率(9.5%对7.5%,P=1.000)差异无统计学意义。结论 SBT安全性筛查宽松标准比SBT安全性筛查传统标准更有优越性,可以作为常规筛选标准应用于临床。
[Abstract]:Objective to evaluate the efficacy and safety of relaxed safety screening criteria for spontaneous respiratory test (SBT) in patients with ICU in intensive care unit (ICU). Methods 82 cases of ICU admitted to Zhejiang traditional Chinese Medicine Hospital from December 2010 to May 2011 were selected. Patients with mechanical ventilation, The randomized double-blind control method was used to divide the SBT safety screening system into two groups: the loose standard group (42 cases) and the traditional SBT safety screening group (40 cases). Results of SBT safety screening standard, The weaning and extubation time and mechanical ventilation time of the two groups were compared, and the mortality rate of ICU was 28 days. Results the maintenance time of off-line state in the loose standard group was longer than that in the traditional standard group, and the duration of mechanical ventilation was shorter than that of the traditional standard group. The duration of mechanical ventilation was shortened by 3 days to 7.5 days, and the ICU hospitalization time was shortened by 11 days to 17 days, the mortality rate was lower than that of the traditional standard group. The mortality rate was 14.3% lower than that of the traditional standard group. There was no significant difference in the rate of accidental extubation (2.4% vs 7.5g) and the rate of re-intubation (9.5% vs 7.5p 1.000). Conclusion the loose standard of SBT safety screening is superior to the traditional standard of SBT safety screening. It can be used as a routine screening criterion in clinic.
【作者单位】：浙江省中医院ICU;浙江大学医学院附属妇产科医院影像科;温州医学院附属第一医院ICU;
【基金】：浙江省中医药重点学科建设计划-中西医结合重症医学(2012-XK-A12)
【分类号】：R563.8

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