呼吸机困难撤机23例治疗分析

目的 总结导致困难撤机的相关因素. 方法 收集2007年1月至2008年1月中国医科大学附属第一医院急诊监护室收治的23例行机械辅助通气,预后为困难撤机的患者的临床资料,回顾性的分析他们的治疗过程及可能与之相关的因素. 结果 23例困难撤机的患者中,在撤机后48 h内出现体温＞38℃,咳痰困难,肺部听诊湿性啰音增多的有6例;出现呼吸肌疲劳,动脉血气回报出现PaCO2＞60 mm Hg的有12例;考虑出现呼吸机依赖心理因素的有3例;撤机时机把握不佳导致的撤机困难的有2例. 结论 对患者的临床状况进行及时的评价,合理地保护性机械通气,足够的营养支持,提高患者主观的撤机信心,能提高撤机成功率,减少困难撤机的发生.

Treatment of 23 patients with difficult weaning from respiration support

Objective To sum the factors associated with mechanical ventilation assistant difficulty in weaning of mechanical ventilation. Methods Data of 23 patients, in the First Hospital of China Medical University between January 2007 to January 2008,with mechanical ventilation but for difficult weaning were retrospectively analyzed. Results In 23 patients with difficult weaning, there were 6 cases with temperature > 38 ℃,12 cases with PaCO2> 60 mm Hg,3 cases with psychological dependence on ventilator, and 2 cases with improper time in weaning. Conclusions Timely assess of the patients' symptom, reasonable protective mechanical ventilation, enough nourishment support may reduce incidence of difficult weaning, and enhance achievement ratio of weaning of mechanical ventilation.