撤机指数计分法对ICU机械通气患者撤机成功预测意义的初步评价

Preliminary Evaluation of Weaning Index Scoring for Predicting Successful Weaning from Mechanical Ventilation in ICU Patients

目的研究撤机指数计分法对ICU机械通气患者撤机成功的预测意义。方法以80例气管插管后行呼吸机治疗的重症患者为观察目标,记录患者年龄、最大吸气压力、自主潮气量、呼吸机使用时间、自主呼吸频率、氧合指数、PCO2、血红蛋白,以患者咳嗽反射能力、营养状况、撤机试验、原发病转归、是否有严重并发症等参数作为呼吸机撤机指数的指标,并进行量化评分。结果撤机成功者60例(成功组),撤机失败者20例(失败组),成功组撤机指数计分明显高于失败组[(16.95±1.17)分比(13.50±1.64)分,P<0.05];以撤机指数计分16作为预测撤机成功的临界值,则撤机成功的敏感性达95.00%、特异性达90.00%,阳性预测值达96.61%,撤机指数计分评估撤机成败的临床符合率达93.75%。结论撤机指数计分法对机械通气患者撤机的成功有预测意义。

Objective To evaluate the value of weaning index scoring for predicting successful weaning from mechanical ventilation in ICU patients. Methods The age, maximum inspiratory pressure, spontaneous tidal volume, ventilation duration, spontaneous breathing frequency,oxy- genation index,PCO2 and hemoglobin were recorded in 80 patients who were treated with me- chanical ventilation after tracheal intubation in ICU. Cough reflex sensitivity, nutritional status, weaning trial, primary disease outcome and serious complications were regarded as indicators of ventilator weaning index. All parameters were scored quantitatively. Results Among the 80 pa- tients,60 underwent successful weaning （successful group） and 20 underwent failed weaning （failed group）. The scores of weaning index in successful group were significantly higher than those in failed group [（16.95±1.17） vs （13.50±1.64）,P〈0.05]. The weaning index score 16 was regarded as the threshold value of successful weaning. The sensitivity, specificity, positive predictive value and clinical coincidence rate of successful weaning from mechanical ventilation were 95.00%,90.00%,96. 61% and 93. 75%,respectively. Conclusion Weaning index scoring can be used to predict successful weaning from mechanical ventilation.