浅快呼吸指数、碱剩余在预测COPD患者有创机械通气撤机中的应用价值

Application Value of Shallow Fast Breathing Index and Alkali Residue in Predicting Weaning of Invasive Mechanical Ventilation in COPD Patients

目的:探讨浅快呼吸指数(RBSI)、膈肌浅快呼吸指数(D-RBSI)、碱剩余(BE)在预测慢性阻塞性肺疾病(COPD)患者有创机械通气撤机中的价值。方法:选择我院2018年2月-2021年3月间收治的91例有创机械通气的COPD患者。根据患者撤机结果,对比分析撤机成功者与失败者RBSI、D-RBSI、BE水平,采用Pearson法分析RBSI、D-RBSI、BE与撤机结果的相关性,绘制ROC曲线评价RBSI、D-RBSI、BE对撤机结果的预测价值。结果:91例患者中,撤机成功者61例,成功率67.03%;撤机失败者30例,失败率为32.97%。观察组RBSI、D-RB-SI、BE均低于对照组(P<0.05);RBSI、D-RBSI、BE与患者成功撤机结果呈负相关性(r^(2)=-0.638、-0.711、-0.524,P均<0.05);ROC曲线下,RBSI、D-RBSI、BE的AUC面积无明显差异(P>0.05),RBSI在42.33次/min/L、D-RBSI在1.15次/min/mm、BE在-3.27 mmol/L时具有较好的敏感度和特异度。结论:RBSI、D-RBSI、BE在预测COPD患者有创机械通气撤机中具有重要的预测价值,通过对上述指标进行监测,可为患者撤机结果提供指导。

Objective:To explore the value of rapid shallow breathing index (rbsi),diaphragmatic rapid shallow breathing index (d-rbsi) and residual base (be) in predicting weaning of invasive mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD).Methods:91 COPD patients with invasive mechanical ventilation in our hospital from February 2018 to March 2021 were selected.According to the results of weaning,rbsi,d-rbsi and be levels of successful and unsuccessful patients were compared and analyzed.Pearson method was used to analyze the correlation between rbsi,d-rbsi and be and weaning results.ROC curve was drawn to evaluate the predictive value of rbsi,d-rbsi and be for weaning results.Results:Among the 91 patients,61 patients were successfully weaned,the success rate was67.03%;30 patients failed to wean,the failure rate was 32.97%.Rbsi,d-rbsi and be in the observation group were lower than those in the control group (P<0.05);Rbsi,d-rbsi and be were negatively correlated with successful weaning (R^(2)=-0.638,-0.711,-0.524,all P<0.05);Under the ROC curve,there was no significant difference in AUC area among rbsi,drbsi and be (P>0.05).Rbsi had good sensitivity and specificity at 42.33 times/min/l),d-rbsi at 1.15 times/min/mm and be at-3.27mmol/L.Conclusion:rbsi,d-rbsi and be have important predictive value in predicting weaning of invasive mechanical ventilation in COPD patients.Monitoring the above indicators can provide guidance for weaning results.