合并心功能不全呼吸衰竭患者机械通气脱机回顾性分析

Retrospective Analysis of Mechanical Ventilation Weaning in Patients with Cardiac Insufficiency and Respiratory Failure

目的探讨合并心功能不全呼吸衰竭患者机械通气脱机困难的原因,寻找有效的脱机措施。方法选择惠州市中山大学附一院惠亚医院63例合并心功能不全呼吸衰竭患者为研究对象,分为呼吸机依赖组与非依赖组,分析两组患者的血气、血检及BNP、LVEF等指标情况,对顽固性呼吸机依赖组患者进行强化营养、改善心肺功能、调整水电解质平衡、加强呼吸功能定时训练,强化心理素质,使其每日定时脱机,最终达到完全性脱机。结果 17例顽固性呼吸机依赖者最终全部脱机。结论营养不良、心肺功能不全、心理等因素是呼吸机依赖的影响因素;强化营养、调整电解质平衡,改善心肺功能,增强心理素质,循序渐进脱机是有效的脱机方法。

Objective To explore the causes of the difficulty of mechanical ventilation in patients with combined cardiac insufficiency,and find effective offline measures. Methods 63 patients with heart failure complicated with respiratory failure were analyzed retrospectively. They were divided into ventilator dependent group and non-dependent group. Blood gas analysis,blood test,BNPL and LVEF were analyzed. The patients with intractable ventilator dependent group were given intensive nutrition to improve cardiopulmonary function,adjust the balance of water and electrolyte,strengthen the regular training of respiratory function,strengthen psychological quality, and complete offline everyday. Results Among them, 17 cases of intractable ventilator dependence were completely weaned. Conclusion Malnutrition,cardiopulmonary insufficiency and psychological factors are the influencing factors of ventilator dependence. Strengthening nutrition,adjusting electrolyte balance,improving cardiopulmonary function,enhancing psychological quality and gradually weaning are effective offline methods.