新生儿机械通气撤机失败影响因素调查与防护对策

Investigation on the factors influencing the failure of ventilator weaning and the protective countermeasures in neonatal with mechanical ventilation

目的探讨新生儿机械通气撤机失败的影响因素并制定防护对策,为临床新生儿实施适宜精准的机械通气及预防撤机失败提供依据。方法选取2017年1月至2019年1月在我院行机械通气治疗的新生儿232例为研究对象,观察发生撤机失败情况,收集患者一般资料,分析影响撤机失败的因素,并进行多因素logistic回归分析。结果 232例机械通气的新生儿中,发生撤机失败26例,失败率11. 21%。多因素logistic回归分析结果显示,胎龄未足月、无营养支持、发生多脏器功能损伤及发生呼吸机相关性肺炎是新生儿机械通气撤机失败的独立危险因素(P <0. 05)。结论影响新生儿机械通气撤机失败的因素较多,针对高危因素采取有效措施提早预防,可减少撤机失败,改善预后。

Objective To explore the influencing factors of the failure of ventilator weaning in neonatal with mechanical ventilation and develop protective countermeasures to provide a basis for clinical newborns for implementing appropriate precision mechanical ventilation and preventing the failure of ventilator weaning. Methods We selected 232 neonates who underwent mechanical ventilation in our hospital from January 2017 to January 2019 as a study object. The failure of the ventilator weaning was observed and the general data of the patients were collected to analyze the factors affecting the failure of the ventilator weaning. Multivariate logistic regression analysis was also used in the analysis. Results In the 232 neonates with mechanical ventilation,26 cases had a failure of ventilator weaning with a failure rate of 11. 21%. Multivariate logistic regression analysis showed that gestational age less than adequate month,no nutritional support,multiple organ damage,and ventilator-associated pneumonia were independent risk factors of neonatal mechanical ventilation withdrawal( P < 0. 05). Conclusion There were many factors affecting the failure of ventilator weaning in neonatal with mechanical ventilation,Taking effective measures to prevent early prevention of high-risk factors could reduce the failure of weaning and improve the prognosis.