有创机械通气呼吸机依赖患者的治疗临床研究

Clinical study on mechanical venlilation dependant pationts with invasive positive pressure venlilation

目的探讨机械通气患者发生呼吸机依赖的临床特点、原因和治疗对策。方法对已成功撤机的18例呼吸机依赖患者进行回顾性分析。结果本组18例全部撤机存活,无1例在1周内因呼吸因素再次插管上机或死亡。影响撤机困难主要原因有:营养不良、心、肺功能不全和心理依赖等因素。结论有创机械通气能否成功撤机,依赖于临床医师撤机时机的掌握,与患者基础疾病、营养状态、呼吸功能和其他脏器的功能密切关联。加强病因治疗及有利撤机等综合有效措施,可提高呼吸衰竭治疗的成功率,安全撤机可行。

Objective To investigate the clinical features, causes and remedial strategy of mechanical ventilation dependant in 18 patients with invasive positive pressure ventilation（IPPV）. Methods Eighteen patients who depended on mechanical ventilation and withdrew successfully were reviewed retrospectively. Results Fourteen patients who depended on mechanical ventilation all survived, none of them necessitates second intubation in one week. The main causes of depending on mechanical ventilation were malnutrition, pulmonary and cardiac insufficiency,and mental dependant. Conclusions Success withdrawal of IPPV depends on the physician＇ s skill to judge the occasion, and also closely related to primary diseases, nutritional status and pulmonary function and so on. Reinforce the etiological treatment and take comprehensive measures which benefit to withdrawal of ventilator may enhance the suscess rate of treating respiratory failure.