浅快呼吸指数指导AOPP患者撤机的临床研究

目的探讨浅快呼吸指数(light fast breathing index RSBI)作为急性有机磷中毒(acute organophosphate poisoning,AOPP)患者撤机的临床价值。方法重症医学科20例机械通气的AOPP患者均通过了1h的自主呼吸实验(spontaneous breath-ing test SBT),记录了2个时期的RSBI:SBT前、SBT1h,同时记录年龄、性别、APACHEⅡ评分、撤机前30min的动脉血气分析及胆碱酯酶活力(choline esterase vigo CHE)。结果 15例AOPP患者成功撤机,5例患者撤机失败,在成功和失败两组年龄、性别、A-PACHEⅡ评分无明显差异(P>0.05),CHE有明显差异(P<0.05),以RSBI≤105 bpm/L为标准预测撤机成功的灵敏度和特异度分别为:SBT前SBT1 92.8%、10.2%,SBT1h的RSBI预测撤机成功的灵敏度和特异度分别为93.6%、40.5%。SBT1h的RSBI与CHE联合预测撤机成功的灵敏度和特异度分别为90.5%、75%。结论 SBT1h的RSBI预测AOPP撤机成功的准确性高于SBT前,其与CHE联合评价将提高预测撤机成功的准确性。

Shallow breathing quickly withdraw machine of clinical research index guiding AOPP patients

Objective to study the shallow breathe fast index as the clinical value of AOPP patients withdraw machine. Methods mechanical ventilation of patients with AOPP were 20 patients with severe medicine through the spontaneous breathing test （SBT） 1 h, recorded the RSBI of two periods： before the SBT, SBTlh, at the same time, record the age, gender, APACHE II score, 30 min before removal machine of arterial blood gas analysis, and cholinesterase （CHE） vigor. Results 15 cases of AOPP patients withdraw machine successfully, 5 patients withdraw machine failure, success and failure in the two groups in age, gender, APACHE II score has no obvious difference （ P 〉 0. 05 ）, CHE have obvious difference （ P 〈 0. 05 ）, the prediction based on RSBI 105 BPM/L or less ventilator successful sensitivity and specific degrees respectively： before the SBT SBT1 were 92. 8%, 10.2%, the RSBI SBTlh successfully predict ventilator sensitivity and specific degree 93.6%, 40. 5% respectively SBTlh RSBI with CHE forecast ventilator successful sensitivity and specific degree 90. 5%, 75% respectively. Conclusion the RSBI SBTlh successfully predict AOPP withdraw machine accuracy is higher than before the SBT, its associated with CHE evaluation will improve the accuracy of prediction withdraw machine successfully.