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目的分析影响急性左心衰竭患者呼吸机撤离的相关因素。方法回顾性分析急性左心衰竭行机械通气治疗120例患者的临床资料。结果单因素回归分析结果表明,原发病、并发症等26项因素对撤机过程有影响。多因素回归分析结果表明,基础心功能、肺部感染、急性生理学和慢性健康状况评估(APACHEⅡ评分)和有创机械通气时间是影响撤机的独立危险性因素。良好的咳嗽排痰能力是撤机过程的有利因素。采用自主呼吸试验撤机成功率最高。结论基础疾病、肺部感染、APACHEⅡ评分和有创机械通气时间是影响急性左心衰竭患者撤机的独立危险性因素。
Objective To analyze the related factors that affect the evacuation of ventilator in patients with acute left heart failure. Methods The clinical data of 120 patients with acute left ventricular failure treated with mechanical ventilation were retrospectively analyzed. Results The results of univariate regression analysis showed that 26 factors such as primary disease and complications had an impact on the weaning process. Multivariate regression analysis showed that baseline heart function, pulmonary infection, acute physiology and chronic health assessment (APACHEⅡscore) and invasive mechanical ventilation were independent risk factors for weaning. Good cough expectoration capacity is a favorable factor in the weaning process. With spontaneous breathing test the highest success rate of weaning. Conclusions The underlying diseases, pulmonary infection, APACHEⅡscore and invasive mechanical ventilation are independent risk factors for weaning in patients with acute left heart failure.