重症患者两种撤机方式的比较

Comparison of two weaning methods used in intensive care patients

目的比较SmartCare/PS(SC)和压力支持通气(PSV)模式在重症患者中的撤机效果。方法将41例行机械通气的重症患者,在满足临床撤机条件后,随机分为SC组(n=21)和PSV组(n=20),分别采用SC和PSV模式撤机。记录撤机时间、总通气时间(TVT)、人工操作次数,以及再插管率、气管切开率、气胸发生率和呼吸机相关肺炎(VAP)发生率。结果 SC组撤机时间、TVT较PSV组明显缩短(P<0.05);SC组人工操作次数较PSV组明显减少(P<0.05);两组再插管率、气管切开率、气胸发生率和VAP发生率差异无统计学意义。结论 SC模式可缩短重症患者的撤机时间、TVT和减轻医务人员工作量。

Objective To investigate the weaning effect of SC and PSV methods in intensive care patients. Methods After fitting clinical weaning condition forty-one intensive care patients on mechanical ventilation were randomized into 2 groups： weaning with SC（n= 21 ） or with PSV（n= 20）. The weaning time, total ventilation dine, the manual setting changes while weaning and the rate of the reintubation, tracheotomy, pneumothorax and ventilator-associated pneumonia were recorded. Results The weaning time and total ventilation time was obviously shorter in SC group（P〈0.05） ; the manual setting changes while weaning was obviously less in SC （P〈 0.05）; No significant difference in the rate of the reintubation, tracheotomy, pneumolhorax and ventilator-associated pneumonia was detected between the two groups. Conclusion SC method can shorten the weaning time, TVT so that to reduce the workload of physicians in ICU.