颅脑疾病机械通气患者撤机的影响因素研究
Predictors in the Ventilator Weaning Process for Patients with Central Nervous System Disease

江美嫦.颅脑疾病机械通气患者撤机的影响因素研究[J].内科急危重症杂志,2017,23(3):

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英文关键词:Central Nervous System Disease, Mechanical Ventilation,Ventilator Weaning

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作者	单位	E-mail
江美嫦	广东省佛山市南海区第六人民医院重症监护室	flykidsjmc1983@163.com

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中文摘要:

目的：分析颅脑疾病机械通气患者撤机的影响因素。方法：回顾性分析2015年6月至2016年9月本院综合ICU收治的颅脑疾病伴机械通气的患者41例，分为撤机容易组（33例）和撤机困难组（8例），分析影响撤机的因素。结果：容易组撤机前的乳酸水平、MV time（机械通气时间）明显低于困难组，而撤机前的GCS 评分、合并咳嗽反射的病人数明显高于困难组，两组比较有统计学差异（P＜0.05）［乳酸：0.94±0.44 mmol/l比1.35±0.40mmol/l，P＝0.022；MV time：5.64±5.55天比13.50±9.21天，P＝0.003；GCS 评分：9.27±1.908分比7.5±1.927分，P＝0.024；咳嗽反射：90.9％比50％，P＝0.025］。良好的咳嗽反射是颅脑疾病机械通气患者撤机的负危险因素［多因素的Logistic分析的OR值=0.032，P=0.041］。结论：乳酸水平、机械通气时间、撤机时的GCS评分、咳嗽反射是颅脑疾病机械通气患者撤机的影响因素；而良好的咳嗽反射是独立影响因素。

英文摘要:

Objective To evaluate the effects of predictors in the ventilator weaning process for patients with Central Nervous System Disease. Methods Totally 41 patients(from 2015-06 to 2016-09) under mechanical ventilation with Central Nervous System Disease were retrospectively studied. The patients were assigned into evacuation ventilator easy group(33 cases) and evacuation ventilator difficult group(8 cases). The influencing factors were analyzed. Results There was significant difference between the easy group and the difficult group in terms of Lactate,MV time,GCS,Cough reflex［Lactate：0.94±0.44 mmol/l VS 1.35±0.40mmol/l，P＝0.022；MV time：5.64±5.55day VS 13.50±9.21day，P＝0.003；GCS：9.27±1.908 VS 7.5±1.927，P＝0.024；Cough reflex：90.9％ VS 50％，P＝0.025］.The cough reflex was the significant variables of weaning［OR=0.032，P=0.041］. Conclusion The study shows that Lactate,MV time,GCS,Cough reflex are the effects of predictors in the ventilator weaning process for patients with Central Nervous System Disease; The cough reflex is the most significant variable.