目的：研究动脉血氧饱和度及其变化率对机械通气患者拔管成功率预测价值。方法：采用前瞻性研究方法，选取ICU的机械通气患者63例次，按拔管结果分成2组，比较两组SaO2及ΔSaO2的差异。结果：2组患者性别、年龄差异无统计学意义（P＞0．05）。2组患者的SaO2－30、ΔSaO2差异有统计学意义（P＜0．05）。 SaO2－30与拔管成功率显著正相关（P＜0．05），ΔSaO2与拔管成功率显著正相关（P＜0．05）。SaO2－30和ΔSaO2 ROC下面积分别为0．689、0．733。ΔSaO2的截断点为0．026（敏感性97．2％，特异性86．4％）。结论：SaO2下降＜2．6％是拔管成功的可靠预测指标，ΔSaO2对机械通气患者拔管成功率的判断有一定的临床价值。%Objective: To study the predictive value of arterial blood oxygen saturation and the change rate and the success rate of extubation in patients with mechanical ventilation. Methods: A perspective study was conducted. 63 patients with mechanical ventilation in ICU were divided into two groups according with extubation results. The difference of SaO2 and ΔSaO2 were compared. Results: No significant differences were found in the items such as age and sex among both groups (P>0.05). There were differences on the change rate of SaO2-30 and ΔSaO2 between two groups (P<0.05). There were significant correlation between SaO2-30 and the success rate of extubation (P<0.05), as well as between ΔSaO2 and the success rate of extubation (P<0.05). The areas under the ROC curve of SaO2-30 and ΔSaO2 were 0.689 and 0.733. The cut off value of the change rate of ΔSaO2 was 0.026 (sensitivity of 97.2%, specificity of 86.4%). Conclusion: The decrease of SaO2<2.6% can b used as a predictor of the extubation success. It is certain clinical value to determine the success rate of extubation in patients with mechanical ventilation by the change rate of ΔSaO2.
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