22例患者ICU脱机困难的原因分析
沈锋,李亭雨,白霖果,鲁文婉,林森
摘要(Abstract):
目的:探讨重症监护病房(ICU),脱机困难的原因及对策。方法:对成功脱机的22例ICU脱机困难患者的临床资料进行分析,总结脱机困难的基础病因、主要原因、呼吸机治疗时间以及治疗方法。结果:22例脱机困难患者的基础病因主要包括脑血管意外、严重创伤及重症肺炎,造成脱机困难的主要原因有周围性呼吸衰竭、中枢性呼吸功能障碍以及重症肺炎等;呼吸机治疗时间以中枢性呼吸功能障碍患者最长,其次为周围性呼吸衰竭及重症肺炎患者,呼吸机平均治疗时间为25 d;22例患者均为有创机械通气,其中6例患者先采用辅助/控制通气模式,后改用同步间歇指令通气(SIMV)+压力支持(PSV)通气,其他16例患者始终采用SIMV+PSV模式;12例患者采用经口气管插管,其中11例患者治疗5~10 d后改为气管切开,1例始终采用经口气管插管;10例患者始终采用气管切开。结论:对于脱机困难患者,需积极正确找出脱机困难的原因,采取相应的有效处理可提高ICU脱机困难患者的脱机成功率。
关键词(KeyWords):
重症监护病房;呼吸机;呼吸衰竭;插管法,气管内;气管切开术
基金项目(Foundation):
作者(Author):
沈锋,李亭雨,白霖果,鲁文婉,林森
DOI: 10.19367/j.cnki.1000-2707.2013.06.027
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