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目的 :探讨老年术后患者脱机困难的相关因素。方法 :收集92例术后入住南京医科大学第一附属医院老年ICU的患者,均在达到撤机标准后进行撤机,根据48 h内撤机成功与否分为成功组与失败组。采用回顾性方法分析相关信息,筛选出影响撤机的相关因素,应用多因素非条件Logistic回归进行回归分析。结果:92例术后呼吸机辅助呼吸的老年患者中,24例48h内撤机失败,发生率26.1%。失败组患者APACHE-Ⅱ评分、吸气压、氧分压、吸氧浓度均高于成功组,氧合指数低于成功组,行急诊手术、脑外科术后、住院期间多重耐药菌感染与成功组比较差异显著(P<0.05)。脑外科术后、住院期间多重耐药菌感染、APACHE-Ⅱ评分高、吸气压高是撤机失败的独立危险因素(P<0.05)。结论 :脑外科术后、住院期间多重耐药菌感染、APACHE-Ⅱ评分高、吸气压高是老年术后患者撤机困难的独立危险因素。
Objective: To explore the related factors of postoperative elderly patients with offline difficulty. Methods: A total of 92 patients admitted to the First Affiliated Hospital of Nanjing Medical University after the operation were enrolled in the study. The patients were weaned after reaching the standard of weaning. According to whether the weaning was successful within 48 hours, the patients were divided into two groups: successful group and failed group. The retrospective method was used to analyze the related information, the factors that affected the weaning were screened out, and the regression analysis was carried out by multivariate non-conditional Logistic regression. Results: Of 92 elderly patients who received ventilator assisted breathing, 24 patients failed to weaning within 48 hours, with a rate of 26.1%. APACHE-Ⅱ score, inspiratory pressure, partial pressure of oxygen and oxygen concentration in the failure group were higher than those in the successful group, and the oxygenation index was lower than that in the successful group. In the emergency group, the patients with multiple drug- The successful group was significantly different (P <0.05). After brain surgery, multiple drug-resistant bacterial infections during hospitalization, high APACHE-Ⅱ score and high inspiratory pressure were independent risk factors for weaning failure (P <0.05). Conclusion: After the surgery of the brain, multi-drug resistant bacterial infections, high APACHE-Ⅱ score and high inspiratory pressure during hospitalization were independent risk factors for weaning difficulty in elderly patients.