机械性吸呼气技术对预防机械通气再插管的影响分析

Analysis of the influence of mechanical inhalation and exhalation technology on preventing reintubation of mechanical ventilation

目的分析机械性吸呼气技术(MI-E)对预防呼吸重症监护室(RICU)机械通气再插管的影响。方法选取2018年1月至2019年10月于本院RICU行机械通气≥48 h、通过自主呼吸实验(SBT)的128例患者作为研究对象,按照随机数字表法分为对照组(n=56)和实验组(n=72),对照组采用常规脱机方法治疗,实验组在对照组基础上采用MI-E治疗。比较两组拔管后48 h应用无创通气状况、再插管情况及RICU留置时间。结果脱机后48 h内,两组无创通气失败率比较差异无统计学意义;实验组再插管率为19.44%,低于对照组的42.86%,差异有统计学意义(P<0.05);实验组RICU停留时间为(3.12±2.41)d,短于对照组的(9.87±6.65)d,差异有统计学意义(P<0.05)。结论拔管后应用MI-E,既能降低机械通气患者拔管后再插管率,且能减少RICU留置时间,值得临床推广应用。

Objective To analyze the effect of mechanical insufflation-exsufflation(MI-E)on preventing of reintubation of mechanical ventilation in respiratory intensive care unit(RICU).Methods 128 patients who had mechanical ventilation≥48 h and passed the spontaneous breathing test(SBT)in RICU of our hospital from January 2018 to October 2019 were selected as the research subjects,and they were divided into the control group(n=56)and the experimental group(n=72)according to random number table methods.The control group were treated with conventional offline method,the experimental group received MI-E treatment on the basis of the control group.The noninvasive ventilation,reinsertion 48 h after extubation and RICU retention time were compared between the two groups.Results Within 48 h after weaning,there was no significant difference in the failure rate of noninvasive ventilation between the two groups;the intubation rate in the experimental group was 19.44%,which was lower than 42.86%in the control group,the difference was statistically significant(P<0.05).The RICU residence time in the experimental group was(3.1±2.4)d,which was shorter than(9.8±6.6)d in the control group,the difference was statistically significant(P<0.05).Conclusion The application of MI-E after extubation can not only reduce the reintubation rate of mechanical ventilation patients after extubation,but also reduce the retention time of RICU,which is worthy of clinical promotion and application.