膈肌功能评估在撤机中的指导意义

Guiding significance of diaphragm function evaluation in ventilation weaning

膈肌功能障碍临床较常见,也是常常被临床医师忽略的导致机械通气（MV）撤机失败的重要原因.撤机时评估膈肌功能可以早期发现和预防撤机失败,从而改善MV患者的临床结局.回顾膈肌功能评估用于撤机的研究发现,撤机中评估膈肌功能可指导撤机.膈肌功能相关撤机预测指标包括压力指标、电生理指标、形态学指标等,其中床旁超声作为形态学指标,在重症加强治疗病房（ICU）应用广泛,具有简单、无创、易操作的优点,在评估膈肌功能指导撤机上准确性高,值得临床推广应用.

Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation （MV）. Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit （ICU）, which is simple, non-invasive, and easy to operate. It is also accurate in the assessment of diaphragmatic function and guidance on weaning, which is worthy of promotion and application.