慢性阻塞性肺疾病急性加重期患者撤机困难的原因分析及对策

A causing analysis and countermeasures of weaning difficulty during COPD acute exacerbation

目的:回顾机械通气慢性阻塞性肺疾病急性加重期患者撤机困难的原因,探讨应对策略。方法:对2013-2015年在我科接受机械通气的AECOPD患者的临床资料进行分组分析,观察年龄、性别、撤机成功率、撤机困难率、心理因素和机械通气时间等相关因素的差异性。结果:行机械通气期间,40例患者中出现10例撤机困难,发生率为25%。经分析,气管插管管径、镇静程度、气道梗阻、机械通气时间长均为撤机困难的相关因素。结论:积极寻找导致患者撤机困难的原因,针对不同因素制定防治措施,可有效降低撤机困难的发生率。

Objective： Causes of weaning difficulty during COPD acute exacerbation were analyzed; the countermeasures were investigated. Methods： Clinical data of patients were analyzed. The differences between groups of age, gender, weaning success, weaning difficulty, psychological factors, duration of mechanical ventilation and other relevant factors were observed. Results： There had been weaning diffculty in 10 patients, accounting for 25%. Diameter of endotracheal tube, extent of sedation, airway obstruction and mechanical ventilation for a long time were related factors of weaning difficulty. Conclusion： Actively looking for causes of weaning difficulty, developing control measures for different factors could effectively reduce the incidence of weaning diffculty.