肺移植术后膈肌移动度与自主呼吸试验期间呼吸功能参数的相关性

Correlation between diaphragm excursion measured after lung transplantation and respiratory function parameters during spontaneous breathing trials

目的应用超声测量肺移植术后患者膈肌移动度(DE),分析其与自主呼吸试验(SBT)期间呼吸功能参数的相关性。方法选取于我院心肺诊疗中心行肺移植术患者114例,根据肺移植术后通过SBT的初次撤机结果分为撤机成功组92例和撤机失败组22例,均于SBT期间监测呼吸功能参数,包括血氧分压(PaO_(2))、潮气量(VT)、浅快呼吸指数(RSBI)及呼吸机支持时间;应用超声测量DE,比较两组上述参数的差异。采用Pearson相关分析法分析DE与呼吸功能参数的相关性。结果撤机成功组DE、PaO_(2)、VT均高于撤机失败组,RSBI低于撤机失败组,呼吸机支持时间短于撤机失败组,差异均有统计学意义(均P<0.05)。相关性分析显示,DE与PaO_(2)、VT、RSBI及呼吸机支持时间均存在相关性(r=0.478、0.734、-0.593、-0.567,均P<0.05)。结论肺移植术后超声所测DE与SBT期间呼吸功能参数均相关,可用于肺移植术后呼吸功能的评估以指导撤机时机的选择。

Objective To analyze the correlation between diaphragm excursion(DE)measured by ultrasound after lung transplantation and respiratory function parameters during spontaneous breathing trial(SBT).Methods A total of 114 patients who underwent lung transplantation were selected from the Cardiopulmonary Diagnosis and Treatment Center of our hospital.Based on the results of the first SBT after lung transplantation,the patients were divided into successful weaning group(n=92)and failed weaning group(n=22).Respiratory function parameters,including partial pressure of arterial oxygen(PaO_(2)),tidal volume(VT),rapid shallow breathing index(RSBI)and duration of ventilator support were monitored during SBT.DE was measured by ultrasound,and the differences of above parameters between the two groups were compared.Pearson correlation analysis was used to analyze the correlation between DE and respiratory function parameters.Results The DE,PaO_(2)and VT in the successful weaning group were higher than those in the failed weaning group,while RSBI was lower than that in the failed weaning group,the ventilator support time was shorter than that in the failed weaning group,with statistical significant differences(all P<0.05).Correlation analysis showed that DE was correlated with PaO_(2),VT,RSBI and duration of ventilator support(r=0.478,0.734,-0.593,-0.567,all P<0.05).Conclusion After lung transplantation,DE measured by ultrasound is correlated with respiratory function parameters during SBT.It can be used to evaluate respiratory function after lung transplantation and guide the selection of extubation timing.