膈肌超声在机械通气患者撤机结果预测中的应用价值

Application value of diaphragmatic ultrasound in prediction of patients weaning from mechanical ventilation

目的评价膈肌超声对ICU机械通气(mechanical ventilation,MV)病人撤机结果预测中的应用价值。方法选取在2018年12月至2019年4月期间收住安徽医科大学第一附属医院高新院区重症医学科符合纳入标准21例患者,撤离呼吸机后行超声检查膈肌,根据撤机成功与否,将患者分为撤机成功组和撤机失败组。结果撤机成功组膈肌活动度(diaphragm excursion,DE)、吸气末膈肌厚度(diaphragmatic thickness at the end of inspiration,DTei)、呼气末膈肌厚度(diaphragmatic thickness at the end of expiration,DTee)、膈肌增厚率(diaphragm thickening fraction,DTF)均明显高于撤机失败组,差异有统计学意义,ROC曲线提示DE、DTei、DTee、DTF均可预测撤机是否成功。结论超声监测膈肌,有助于预测机械通气患者撤机结果。

Objective To evaluate the value of diaphragmatic ultrasound in ICU patient weaning from mechanical ventilation.Methods It selected 21 patients with mechanical ventilation who met the inclusion criteria in the intensive care department of the first affiliated hospital of Anhui medical university from December 2018 to April 2019.Weaning from mechanical ventilation,they were given ultrasound examination.The patients were divided into two groups according to the success or failure of weaning from mechanical ventilation.Results The range of diaphragm activity,diaphragm thickness and diaphragm thickening rate of the successful group were significantly greater than those of the failure group,with statistically significant differences.ROC curve prompt DE,DTei,DTee and DTF could all predict the success of weaning from mechanical ventilation.Conclusion Ultrasound monitoring of diaphragm is helpful in predicting the outcome of weaning mechanical ventilation.