呼吸机依赖患者相关因素分析

目的研究导致呼吸机依赖的患者因素及可能的药物性因素。方法比较近5年来收治的因呼吸衰竭接受机械通气治疗的患者，分析呼吸机依赖患者与成功脱机组患者资料。结果成功脱机组139例，呼吸机依赖组16例；入院时两组A-PACHE—Ⅱ评分有显著性差异（P〈0．05），而年龄、PaO2／FiO2、PaCO2在两组之间比较无统计学差异（P〉0．05）；入院后咪达唑仑、哌库溴铵、白蛋白量在两组中存在统计学差异（P〈0．05）；呼吸机依赖组患者中甲状腺功能低下、神经肌肉疾病患者多于成功脱机组。结论患者病情的严重程度会决定脱机的难易；对于脱机困难的患者应及时纠正低蛋白血症、警惕甲状腺功能低下及神经肌肉疾病；尽可能减少镇静剂、肌松剂等药物的应用。

The analysis of related factors of the patients with ventilator dependent

Objective To study the related factors of the patients with ventilator dependence. Methods The data were analyzed on the reference of the two groups of the patients in the last 5 years who received mechanical ventilation because of respiratory failure： in eluding the groups successfully weaning group and ventilator dependence group. Results There were 139 patients in the successfully weaning group and 16 in the ventilator dependence group. There were significant differences between the two groups on APACHE- Ⅱ score （P 〈 0. 05 ） and the administration of midazolam, pipeeuronium, and albumin. There was no significant difference between the two groups on age and PaO2/FiO2, PaCO2 （ P 〉 0. 05 ）. The proportion of hypothyroidism and neuromuscular disease in the ventilator dependence group was higher than that in the successfully weaning group. Conclusion The difficulty of weaning is associated with the severe condition of the patients. Hypoalbuminaemia should be corrected immediately and hypothyroidism and neuromuscular disease should be paid more attention when the patients has the tendency of difficulty to wean. Neuromuscular blockers and sedative should be used with greatest caution.