新生儿机械通气拔管失败相关因素分析

目的:分析新生儿机械通气拔管失败的相关因素。方法:对2003年1月至2007年1月我院新生儿重症监护病房(NICU)168例应用机械通气治疗中出现拔管失败18例的临床资料进行分析。结果:拔管失败率非肺力学监测组较肺力学监测组高(P<0.05);机械通气时间3 d以上组较0~3 d组高(P<0.05);早产儿组较足月儿和过期产儿组高(P<0.05);无静脉营养支持组较静脉营养支持组高(P<0.01);结论:利用肺力学监测指导呼吸机参数调整,加强机械通气管理,适时拔管,是减少拔管失败的重要因素;预防早产,加强患儿营养支持也是减少拔管失败的重要因素。

Analysis of Correlation Factors of Failure to Extubate from Mechanical Ventilation in Newborn

Objective:To analyze the correlation factors of failure to withdraw the endotrached tube from the mechanical ventilation in newborn.Methods:To analyze the correlation factors in 18 of 168 cases,failing to extubate from mechanical ventilation,which were from our neonatal intensive care unit(NICU) during Jan 2003-Jan 2007.Results:The failure rate of extubation(FRE) in non-pneumono dynamics monitoring group was increased significantly than that in pneumono dynamics group when mechanical ventilation was applied to treat respiratory failure in newborn(P<0.05);The FRE in mechanical ventilation beyond 3 days group was significantly different than that in group 0-3days(P<0.05);The FRE in premature infant was strikingly higher than that in group full-term infant and post-term infant(P<0.05);The FRE in non-intravenous nutrition group was also higher than that in intravenous nutrition group(P<0.05).Conclusion:It is suggested that appling the pneumono dynamics monitoring to instructing to adjust breathing machine parameters,using the breathing machine rationally,managing the mechanical ventilation regularly,preventing the ventilator associated lung injury(VALI),withdrawing the endotrached tube from airway at the right moment are significant factors for lessening the failure of extubation.Premature birth being prevented and nutrition being supported are important factors of lessening failure to withdraw the endotrached tube from the mechanical ventilation too.