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目的:探讨浅快呼吸指数(RSBI)对慢性阻塞性肺疾并(COPD)患者机械通气撤机的临床价值。方法:回顾性分析2010年6月~2013年5月在我院RICU住院使用机械通气并符合常规临床撤机标准[1]的35例COPD患者,监测患者RSBI值,然后进行撤机试验,观察RSBI值与撤机结果之间的关系。结果:37例COPD机械通气患者撤机成功28例(75.68%),撤机失败9例(24.32%),撤机成功组RSBI值(79.26±13.75)明显低于撤机失败组(106.27±15.91)(P<0.05),RSBI预测脱机成功的灵敏度为73.0%,特异度55.6%。结论:RSBI测定方法简单易行、无创伤性、无需患者主动配合,对COPD患者机械通气撤机有一定的预测价值,但并非敏感指标,结合临床其他指标可能更可靠。
Objective: To investigate the clinical value of shallow breathing index (RSBI) in patients with chronic obstructive pulmonary disease (COPD) undergoing mechanical ventilation. Methods: A retrospective analysis of 35 patients with COPD admitted to our hospital from June 2010 to May 2013 using mechanical ventilation and meeting the standard clinical weaning standard [1] was performed. The patients were monitored for RSBI, and then weaning test was performed to observe Relationship between RSBI value and weaning outcome. Results: Totally 28 patients (75.68%) were wearable in 37 COPD patients, 9 patients (24.32%) were wearable failure, and RSBI (79.26 ± 13.75) in weaning success was significantly lower than that of weaning failure (106.27 ± 15.91 ) (P <0.05). The sensitivity of RSBI to predict offline success was 73.0% and the specificity was 55.6%. Conclusion: The RSBI method is simple, non-invasive and does not require active cooperation of patients. It has some predictive value for mechanical ventilation and weaning in patients with COPD. However, it is not a sensitive index and may be more reliable in combination with other clinical indexes.