摘要
目的 :研究RVR对机械通气患者撤机的预测价值。方法 :回顾分析过去两年需机械通气治疗的患者104例 ,按照引起呼衰的不同病因分为COPD、ARDS、术后及其他4组。比较常规撤机指标 :RR、VT 、VE 及RVR对机械通气患者撤机的预测价值 ,所有指标都是在BIPAP及CPAP方式下测定的。结果 :除术后组20例全部撤机成功外 ,其他3组中撤机成功组与撤机失败组的RVR分别为 ,COPD组[(58±23)次 / (min·L)vs(80±25)次 /(min·L) ,P<0 05] ,ARDS组[(64±19)次 / (min·L)vs(84±16)次 / (min·L) ,P<0 05]、其他组[(60±21)次 / (min·L)vs(88±21)次 / (min·L) ,P<0 05]。按照机械通气时间的不同分为3组 :≤7天、>7天及撤机失败组 ,RVR分别为 (56±20)次 / (min·L)、(67±17)次 / (min·L)和 (78±23)次 / (min·L) ,P<0 05。以RVR≤105次 / (min·L)为标准 ,预测撤机成功的诊断正确率、灵敏度和特异度分别为82 %、92 %和37 %。结论 :RVR对预测撤机的后果好于常规撤机指标 ,如RR、VT、VE。
To clinically study the rapid shallow breathing index(RVR) measured before weaning as a predictor for weaning patients from mechanical ventilation Methods:A retrospective study was conducted on 104 patients in past two years These patients were divided into a chronic obstructive pulmonary disease(COPD)grouop(n=49),a acute respiratory distress syndrome(ARDS)group(n=13),an postoperative (PO) group (n=20) and an others group(n=22) The outcome of weaning patients from mechanical ventilation was compared between traditional predictors(RR,VT,VE) and RVR All the values were measured on the ventilator with either BIPAP or CPAP Results:Except the PO group that had a total successful weaning,the RVR of success/failure population was (58±23)bpm/L vs(80±25)bpm/L in the COPD group(P<0 05),(64±19)bpm/L vs (84±16)bpm/L in the ARDS group(P<0 05) and (60±21)bpm/L vs(88±21)bpm/L in the others group(P<0 05)respectively The RVR was significantly different between different days of mechanical ventilation;among the groups of ≤7 days,>7 days and failure weaning,the RVR was(56±20)bpm/L,(67±17)bpm/L and(78±23)bpm/L respectively(P<0 05) Using RVR≤105 bpm/L as a threshold value for predicting successful weaning,the diagnostic accuracy,sensitivity and specificity were 82%,92% and 37% respectively Conclusion:RVR was superior to traditional predictors(RR,VT,VE)in predicting weaning outcomes
出处
《天津医药》
CAS
北大核心
2002年第9期527-529,共3页
Tianjin Medical Journal
