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目的探讨呼吸系统功能评分体系对机械通气撤机时机的指导作用。方法采用前瞻性研究方法,对85例接受机械通气的患者根据呼吸系统功能评分结果进行分组:3~4分者为撤机A组(44例),5~6分者为撤机B组(41例),并随机选取同期行机械通气的患者(40例)按传统方法撤机,作为传统组,比较3组患者机械通气时间、撤机成功率、再插管率和呼吸机相关肺炎发生率的差异。结果B组和A组机械通气时间分别为(4.91±0.87)d和(5.11±1.10)d,均明显低于传统组的(7.84±2.27)d,差异有统计学意义(P<0.05);但B组的直接撤机成功率最低,为80.48%,明显低于A组(95.45%)和传统组(100%),差异有统计学意义(P<0.05);A组和传统组再插管率均为0,B组的再插管率为4.88%;呼吸机相关肺炎发生率传统组最高,达27.5%,明显高于A组(11.36%)和B组(14.63%),差异均有统计学意义(P<0.05)。结论在不影响撤机成功率的情况下,采用呼吸系统功能评分(3~4分)撤机,具有更短的机械通气时间和更低的呼吸机相关肺炎发生率,安全可靠,值得临床推广。
Objective To explore the function of respiratory system scoring system on the timing of mechanical ventilation weaning. Methods A prospective study was conducted on 85 patients receiving mechanical ventilation based on respiratory functional scores: 3 to 4 patients were weaned in group A (44 patients), and 5 to 6 patients were weaning B 41 cases) .And randomly selected patients undergoing mechanical ventilation in the same period (40 cases) were weaned according to the traditional method. As a traditional group, mechanical ventilation time, weaning success rate, reintubation rate and ventilator-associated pneumonia were compared Rate difference. Results The durations of mechanical ventilation in group B and group A were (4.91 ± 0.87) d and (5.11 ± 1.10) d, respectively, which were significantly lower than those in conventional group (7.84 ± 2.27) d (P <0.05). However, the success rate of direct weaning in group B was the lowest (80.48%), which was significantly lower than that in group A (95.45%) and traditional group (100%) (P <0.05) The rates of ventilator-associated pneumonia were the highest in conventional group (27.5%), which were significantly higher than those in group A (11.36%) and group B (14.63%), respectively There was statistical significance (P <0.05). Conclusions Weaning with ventilatory system function score (3 to 4) without any effect on the success rate of weaning, with shorter duration of mechanical ventilation and lower incidence of ventilator-associated pneumonia, is safe and reliable and worthy of clinical promotion .