重症监护病房长期机械通气患者撤机困难的原因

目的]分析重症监护室(ICU)长期机械通气患者撤机困难的相关因素.方法]选择在本院ICU中接受机械通气治疗的患者200例,根据撤机结果分为撤机完成组(A组)与撤机困难组(B组),对比分析两组患者的临床资料.结果]A组176例,B组24例,A组气管切开率为15.9％明显低于B组(79.2％),且差异有显著性(P＜0.05)；A组较细管径使用率为34.7％,明显低于B组,且差异有显著性(P＜0.05)；A组呼吸机相关性肺炎、非正常性脱管及操作不当发生率分别为14.8％、6.8％与2.3％,显著低于B组,且差异有显著性(P＜0.05).结论]插管管径、呼吸机相关性肺炎、非正常性脱管、人工气道建立方式以及操作不当等因素均会影响ICU患者成功撤机.

Reason for the Difficulty in Weaning from Mechanical Ventilation of Patients with Long-ternMechanical Ventilation in ICU

Objective]To analyze the reason for the difficulty in withdrawing machine of patient with long- term mechanical ventilation in intensive care unit（ICU）. Methods]Totally 200 patients treated with mechani- cal ventilation in ICU of our hospital were selected. According to the results of withdrawing machine, all pa- tients were divided into the completed weaning group（group A） and the difficult weaning group（group B）. The clinical data of two groups were compared. Results] There were 176 patients in group A and 24 patients in group B. The trachea incision rate in group A was 15.90//oo, which was obviously lower than that in group B （79.2~）, and there was significant difference（ P d0. 05）. The utilization rate of smaller diameter tube in group A was 34.7 ~, which was significantly lower than that in group B, and there was significant difference （ P d0.05）. The incidence of ventilator-associated pneumonia, abnormal detach and the improper operation in group A were 14.8~//oo, 6.8~~ and 2.3~ respectively, which were significantly lower than those in group B, and there were significant differences（ P d0.05）. Conclusion] The diameter of intubation, ventilator-associ- ated pneumonia, abnormal detach, artificial airway establishment and improper operation will affect the suc- cessful rate of weaning in ICU patients.