摘要
目的分析自主呼吸试验(SBT)联合超声评估膈肌功能在ICU机械通气患者撤机过程中的价值。方法选取新余市人民医院2024年1月至11月ICU收治的88例机械通气患者纳入研究。所有患者进行SBT,SBT实施120 min同时实施床旁超声膈肌功能检测随访48 h,根据这些患者撤机成功与否进行分组,研究组为成功撤机组,对照组为撤机失败组。对比两组患者之间SBT、超声参数。结果研究组膈肌浅快呼吸指数(D-RSBI)低于对照组,膈肌活动度(DE)、膈肌增厚分数(DTF)、膈肌在吸气时的收缩速度(DCV)高于对照组,差异均有统计学意义(均P<0.05);绘制ROC曲线发现,SBT联合超声评估膈肌功能参数D-RSBI、DE、DTF、DCV及联合预测ICU机械通气患者撤机失败的AUC分别为0.862、0.893、0.875、0.891、0.990,均有一定价值。结论SBT联合超声评估膈肌功能参数(D-RSBI、DE、DTF、DCV)在预测ICU机械通气患者撤机成功率方面具有高度准确性,可作为有效的临床决策工具。
Objective To analyze the value of spontaneous breathing test(SBT)combined with ultrasound in assessing diaphragm function during the weaning off process of mechanical ventilation in the intensive care unit(ICU)patients.Methods A total of 88 patients with mechanical ventilation admitted to the ICU of Xinyu People's Hospital from January to November 2024 were included in the study.SBT for 120 min plus bedside ultrasound for assessing diaphragmatic function for 48 h was performed on all patients.Patients with a success of weaning off were assigned into the study group,otherwise,they were divided into the control group.SBT and ultrasound parameters were compared between the two groups.Results The diaphragmatic rapid shallow breathing index(D-RSBI)was significantly lower in the study group than the control group,while the diaphragmatic activity(DE),diaphragm thickening fraction(DTF)and diaphragmatic contraction velocity(DCV)during inspiration were significantly higher than those of the control group(all P<0.05).The receiver operating characteristic(ROC)curve was drawn.It was found that the area under the curve(AUC)of SBT combined with the ultrasound parameters of diaphragm function(D-RSBI,DE,DTF,and DCV)in predicting the failure of weaning off was 0.862,0.893,0.875,0.891,and 0.990,respectively,all of which had certain value.Conclusion SBT combined with ultrasound assessment of diaphragm function parameters(D-RSBI,DE,DTF,DCV)is highly accurate in predicting the success of weaning off in ICU patients with mechanical ventilation,and can be used as an effective clinical decision-making tool.
作者
顾雯
徐祖余
江怡
GU Wen;XU Zu-yu;JIANG Yi
出处
《中国疗养医学》
2025年第7期93-96,共4页
Chinese Journal of Convalescent Medicine
基金
新余市社会发展指导性科技计划项目(20243090844)。
关键词
机械通气
重症监护病房
撤机
自主呼吸试验
超声
膈肌功能
Mechanical ventilation
Intensive care unit
Withdraw machine
Spontaneous breathing test
Ultrasound
Diaphragm function
