机械通气治疗COPD撤机失败原因的回顾性研究

目的研究机械通气治疗COPD患者撤机失败的原因。方法收集我院2004年1月至2008年12月住院的38例共45次COPD患者撤机失败、进行回顾性研究，总结撤机失败的原因。结果38例45次撤机失败的原因：感染未控制18例次（40．0％）；呼吸肌疲劳10例次（22．2％）；呼吸机依赖7例次（15．6％）；并发症致再次接机6例次（13．3％）；误吸致再次接机3例次（6．7％），其他1例次（2．2％）。结论有效的抗感染治疗，加强营养支持，防治并发症和注意心理疏导是防止撤机失败的主要措施。

Retrospective study of the reasons of weaning failure in COPD patients treated with mechanical ventilation

Objective To analyze the masons of weaning failure in COPD patients treated with mechanical ventilation in order to provide help for clinical practice. Methods 38 patients with chronic obstructive pulmonary disease （COPD） receiving mechanical ventilation were enrolled in the study,they were admitted into the 105th hospital of PLA during January 2004 and December 2008.45 times weaning failure of these patients with complete clinical date were retro-analyzed, the reasons of weaning failure were summarized and the corresponding countermeasures were discussed. Results The retrospective analysis indicated the following reasons of weaning failure 18 （40. 0% ） uncontrolled infection, 10 （22. 2% ） respiratory muscle fatigue, 7 （ 15.6% ） ventilator - dependent respiratory, 6 （ 13.3% ） ventilator connection again due to oamplieations ,3 （6.7 % ） ventilator connection again due to tniss-inhalation and l （2. 2% ） other tea- son. Conclusion Successful infection treatment,intensified nutritional support, prevention and treatment of complications and early psy- chological guidance are major measures to prevent weaning failure.