三种不同呼吸机撤机效果观察及撤机失败影响因素研究

Observation of Three Different Breathing Machine Effect and Factors Research of Pulled Machine Failure

目的探究3种不同呼吸机撤机失败的原因及撤机效果。方法将中山市博爱医院2015-06—2015-12间重症监护室内进行呼吸机治疗的患者150例作为研究对象,按数字奇偶法随机分为3组,每组各50例,甲组应用呼吸机智能模式脱机,乙组应用医师经验脱机,丙组应用护士主导脱机,比较3组患者撤机效果与成功率。结果 3组患者撤机并发症发生率比较,甲组显著低于乙组,组间比较差异有统计学意义(P<0.05);撤机成功率比较,甲组明显优于乙组、丙组,甲组丙组组间比较差异有统计学意义(P<0.05);呼吸机相关肺炎、血清蛋白水平、机械通气时间及不良的心理因素,是导致撤机失败重要原因。结论呼吸机智能模式撤机方案相较于护士主导撤机及医师经验撤机,成功率最高,且患者并发症少,日常护理可通过对其补充能量,增强心理护理与缩短通气的时间等方式来提高撤机的成功率。

Objective To explore the cause of the failure and pulled effect of three different breathing machines. Methods 150 patients in ICU from June to December,2015 were regarded as the research object,and according to the number parity method,they were randomly divided into 3 groups,with 50 cases in each group. Offline respiratory tact was used in Group A,physician experience offline was used in Group B,and nurse leading offline was used in Group C. Ventilator offline effect and the success rate of the three groups were compared. Results Ventilator weaning complication rates of three groups are compared. Group A is significantly lower than Group B,with statistical significantly difference（ P〈0. 05）. In the comparison of offline success rate,Group A is better than Group B and Group C,with statistical significantly difference（ P〈0. 05）. Ventilator associated pneumonia,serum albumin level,mechanical ventilation time and adverse psychological factors are important reasons causing the failure of ventilator. Conclusion Respiratory intelligent mode offline scheme has higher success rate than nurse leading offline,with less patients＇ complications. Routine nursing can improve the success rate of removal machine through its energy replenishment,psychological nursing strengthening and time shortening.