ICU机械通气患者成功脱机拔管的影响因素分析

摘要

目的 探讨重症加强护理病房(ICU)机械通气患者成功脱机拔管的影响因素.方法 回顾性分析2013年3月～2017年1月火箭军总医院ICU收治的COPD患者89例,收集所有患者各项基本资料,分析ICU机械通气患者脱机拔管的情况,同时依次采用单因素分析和多因素Logistic回归分析方法确定机械通气患者成功脱机拔管的影响因素.结果 89例机械通气患者中成功脱机拔管率为59.55％(53/89)作为成功组,脱机拔管失败和死亡患者36例作为失败组;依次采用单因素和多因素Logistic回归分析法确定年龄(≥50岁)、通气时间(≥7d)、APACHEⅡ(≥30分)、存在感染、ALB＜35 g/L)及存在不良心理是ICU患者成功脱机拔管的影响因素.结论 ICU机械通气患者脱机拔管的成功率并不高,其中年龄、通气时间、APACHEⅡ、感染、ALB及不良情绪是ICU机械通气患者脱机拔管的影响因素,临床上注意危险因素的影响,提高机械通气脱机拔管的成功率.%Objective To explore the influence factors of the successful removal of the mechanical ventilation patients in intensive care unit (ICU).Method 89 cases of patients with COPD admitted in ICU of Rocket Army General from March 2013 to January 2017 were retrospectively analyzed.The various basic information of all patients was collected,and the offline tube drawing of patients with mechanical ventilation in ICU was analyzed.At the same time the influence factors of successful decannulation weaning of patients with mechanical ventilation were detected by using single factor analysis and multivariable Logistic regression analysis method in turn.Results The successful off-line extraction rate of 89 cases of patients with mechanical ventilation was 59.55％ (53/89),which was treated as the successful group,and 36 cases of patients of failure of the extractor and the death were treated as the failure group;The single factor and multiple factors Logistic regression analysis showed that age (≥50 years),ventilation time (≥7 days),APACHE Ⅱ (≥30 points),presence of infection,ALB (＜35 g/L) and the existence of bad psychology was influence factors ofsuccessfully weaning tube drawing of patients in ICU.Conclusion The offline decannulation rate of patients with mechanical ventilation in ICU isn't high,of which age,aeration time,APACHE Ⅱ,infection,propagated and unhealthy emotion are the influence factors of offline tube drawing of the patients with mechanical ventilation in ICU.Pay attention to the clinical risk factors improves mechanical ventilation weaning decannulation rate.