ICU患者机械通气撤机失败原因的分析

Analysis of the Reasons of Unsuccessful Weaning from Mechanical Ventilation of Patients in Intensive Care Unit

目的探讨ICU患者机械通气撤机失败的原因及对策。方法回顾性分析铜陵市人民医院急诊ICU于2012年6-12月收治需要行有创机械通气治疗的40例患者,观察撤机结果,根据治疗后情况分为撤机成功组和撤机失败组,应用SPSS 16.0统计软件对两组相关临床指标进行对比分析。结果两组患者在年龄、血钾水平、格拉斯哥昏迷评分上的差异无统计学意义（P〉0.05）,撤机成功26例（65.0%）,撤机失败14例（35.0%）。与撤机成功组相比,撤机失败组在血红蛋白、血清白蛋白水平、氧合指数上显著低于撤机成功组（P〈0.05）,撤机失败组在白细胞数、机械通气时间、多重耐药菌感染率上高于撤机成功组,差异有统计学意义（P〈0.05）。结论应努力寻找撤机失败原因采取针对性治疗措施,提高撤机成功率。

Objective To study causes and countermeasures of the failure of weaning from me chanical ventialtion of patients in ICU. Methods A retrospective analysis on 40 patients who required invasive mechanical ventilation Tangling People＇s Hospital during Jun. 2012-Dec. 2012 was done, the weaning from mechanical ventilation resuhs was observed and the patients were divided into success group and failure group according to the results, and the clinical indicators of the two groups were analyzed and compared by SPSS 16.0. Results Success in 26 cases （ 65.0% ）, failure in 14 cases （35.0%） ,the age,blood potassium levels,GCS score of the two groups were not significantly different （ P 〉 0.05 ）. Hemoglobin, serum albumin （ ALB ） level, oxygenation index of the failure group were significantly lower than the success group （P 〈 0.05 ）, and the white blood cell count, duration of mechanical ventilation and multiple-drug resistant bacterial infection rate of the failure group were statistically significantly higher than the success group （ P 〈 0.05 ）. Conclusion Reasons of failure of weaning from mechanical ventilation should be found out and pertinent prevention and treatment should be given to increase the success rate of weaning, from mechanical ventilation.