肺移植术后膈肌移动度与自主呼吸试验期间呼吸功能参数的相关性

目的 为分析超声膈肌收缩功能表现与肺移植术后撤机呼吸监测指标间的相关性。方法 选取我院心肺诊疗中心收治的肺移植手术后患者114名,根据肺移植后通过自主呼吸试验(Spontaneous Breathing Test, SBT)的初次撤机结果进行分组,撤机成功组93例,撤机失败组21例,SBT期间监测患者呼吸功能参数,应用超声评估膈肌收缩功能指标膈肌移动度(Diaphragmatic excursion,DE),采用Pearson相关性分析评估撤机期间呼吸监测与膈肌收缩功能关联性。结果 肺移植术后患者存在差异性的膈肌功能下降,呼吸机撤机过程中的DE与氧分压(SPO2)、潮气量(VT)、RSBI及呼吸机使用天数存在一定的相关性(r分别为0.478、0.734、-0.593、-0.567,P均<0.05)。结论 DE与氧分压、潮气量、RSBI及呼吸机使用天数之间具有相关性,可用于肺移植术后呼吸功能的评估。

Analysis of the relationship between weaning respiration monitoring and diaphragm ultrasonic contractile function after lung transplantation

The purpose of this study was to analyze the correlation between ultrasonic diaphragm contractile function and weaning respiratory monitoring after lung transplantation. MethodsA total of 114 patients after lung transplantation in the Heart and Lung diagnosis and treatment Center of our hospital were divided into two groups according to the results of the first weaning test (Spontaneous Breathing Test, SBT) after lung transplantation. 93 patients in the weaning group and 21 patients in the weaning failure group. The respiratory function parameters were monitored during SBT, the diaphragm contractile function was evaluated by ultrasound, and the correlation between respiratory monitoring and diaphragm contractile function during weaning was evaluated by Pearson correlation analysis. ResultsThere was a significant decrease in diaphragm function after lung transplantation. There was a certain correlation between DE and oxygen partial pressure, tidal volume, RSBI and ventilator days (r = 0.478, 0.734,-0.593,-0.567, P respectively < 0.05). ConclusionDE is correlated with oxygen partial pressure, tidal volume, RSBI and ventilator days, and can be used to evaluate respiratory function after lung transplantation.