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目的探讨新生儿机械通气撤机失败的相关因素及护理对策。方法选择2010年1月~2014年3月新生儿重症监护室进行呼吸机通气支持治疗的新生儿320例作为研究对象,比较呼吸机撤机成功及撤机失败两组患儿年龄、性别、体重、有无产伤、Apgar评分、营养状况、多器官功能衰竭;带机过程中呼吸机相关性肺炎(VAP)、机械通气时间时间等方面的差异。结果320例新生儿中撤机失败50例(15.62%),撤机成功组270例(84.38%),单因素检验8个变量是新生儿机械通气撤机失败的相关因素(P<0.05),其危险因素:营养不良(OR=3.78)、合并呼吸机相关性肺炎(VAP)(OR=3.19)、未足月儿(OR=2.99)、多器官功能衰竭(OR=2.75)。结论新生儿机械通气撤机失败发生率较高,影响因素复杂,给予营养支持、积极预防VAP、对于未足月新生儿撤机应掌握指征,多脏器功能损害撤机前做好充分评价以提高撤机成功率。
Objective To investigate the related factors and nursing countermeasures of neonatal mechanical ventilation failure. Methods From January 2010 to March 2014, 320 neonates with neonatal intensive care unit receiving ventilator support were enrolled in this study. The success rate of ventilator weaning and failure of weaning were compared between the two groups in terms of age, sex, weight , With or without injury, Apgar score, nutritional status, multiple organ failure; ventilator-associated pneumonia (VAP) in the process of mechanical ventilation, mechanical ventilation time and other aspects of the difference. Results 320 neonates with weaning failure in 50 cases (15.62%), weaning success in 270 cases (84.38%), univariate test of 8 variables were neonatal mechanical ventilation failure-related factors (P <0.05) Risk factors included malnutrition (OR = 3.78), combined ventilator-associated pneumonia (VAP) (OR = 3.19), unterm infants (OR = 2.99) and multiple organ failure (OR = 2.75). Conclusions The incidence of failure of mechanical ventilation in neonates is high, the factors are complicated, nutritional support is given, and VAP is actively prevented. Indications for weaning of newborn infants should be grasped, and multiple organ dysfunction should be adequately evaluated before weaning To improve the success rate of weaning.