慢性阻塞性肺疾病呼吸机依赖患者脱机方法的研究

Research on measures of weaning from mechanical ventilation-dependency patients with chronic obstructive pulmonary diseases

目的比较慢性阻塞性肺疾病（COPD）呼吸机依赖患者采用Smart Care模式脱机及间歇性停机两种方法的脱机成功率。方法选取2005年1月~2010年1月36例COPD呼吸机依赖患者,将其随机分为试验组和对照组各18例,试验组采用Smart Care模式脱机,对照组采用间歇性停机法脱机。比较两组1周内脱机成功率。结果试验组及对照组1周内脱机成功率分别为66.7%和27.8%,血气分析次数分别为3.5±2.1和6.6±3.7,差异有统计学意义（P〈0.05）;两组平均住院时间及再插管率,差异无统计学意义（P〉0.05）。结论与间歇性停机法相比,COPD呼吸机依赖患者采用Smart Care模式脱机的1周内脱机成功率高,具有重要的临床价值。

Objective To observe the successful rate of weaning from mechanical ventilation-dependency patients with chronic obstructive pulmonary diseases（COPD） adopting Smart Care and intermittent suspending respirator weaning measures. Methods 36 mechanical ventilation-dependency patients with COPD in our hospital from January 2005 to January 2010 were selected and were randomly divided into experimental group and control group,18 cases in each group,the experimental group were taken with Smart Care and the control group were taken with intermittent suspending respirator.The successful rate of weaning in one week between the two groups were compared. Results The successful rate of weaning in one week of the experimental group and control group was 66.7% and 27.8%,the frequency of arterial blood gases analysis was 3.5±2.1 and 6.6±3.7,respectively,the difference was significant（P〈0.05）.However,the difference of the average hospitalization time and the re-intubation rate between the two groups was not significant（P〉0.05）.Conclusion Compared with intermittent suspending respirator,there is higher successful rate of weaning when mechanical ventilation-dependency patients with COPD using the measure of Smart Care,it has important clinical value.