呼吸机依赖的治疗进展

Progress in the clinical treatment of prolonged mechanical ventilation

呼吸机辅助通气是抢救多种原因所致呼吸衰竭的主要措施,应用广泛且效果显著,但随之产生的呼吸机依赖也是常见的并发症。如何预防和降低患者呼吸机依赖的发生率、促进患者呼吸功能康复,是临床治疗和医疗管理发展的目标。本文就临床呼吸机依赖的治疗策略方面进行综述,包括早期识别呼吸机依赖发生的危险因素、呼吸机依赖的治疗(合理使用激素、适当镇静、改善心功能、锻炼肌肉、营养支持、规范撤离呼吸机程序、优质的护理、氧疗、音乐、中医辅助治疗等措施),以期为呼吸机依赖患者的临床治疗特别是集束化治疗提供参考,并对可能产生呼吸机依赖的患者提供预防对策。

The ventilator-assisted ventilation is the main technique of rescuing respiratory failure caused by various reasons,which is widely used and effective,but the subsequent ventilator dependence is also a common complication.How to prevent and reduce the incidence of ventilator dependence in patients and promote the rehabilitation of respiratory function in patients is the goal of the development of clinical treatment and medical management.The article reviews the treatment strategies for clinical ventilator dependence,including early identification of risk factors,treatment of ventilator dependence(rational use of hormones,appropriate sedation,improvement of cardiac function,muscle exercise,nutritional support,standardized procedures for withdrawal of ventilator,excellent nursing,oxygen therapy,music,assisted therapy of traditional Chinese medicine and so on).In order to provide reference for the clinical treatment of ventilator-dependent patients,especially the bundling treatment,and to provide preventive measures for the patients who may develop ventilator-dependence.