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目的分析机械通气患者脱机失败及成功原因,提高脱机成功率。方法对152例机械通气患者(175例次脱机)进行回顾性调查分析。结果带机时间>3 d者脱机成功率87.5%低于带机<3 d者98.1%,差异有统计学意义(P<0.05)。男性患者脱机成功率94.9%与女性患者92.2%比较差异无统计学意义(P>0.05)。合并其他器官疾病者脱机成功率82.9%低于无其他器官疾病者96.4%,差异有统计学意义(P<0.05)。慢性阻塞性肺疾病(COPD)患者脱机成功率87.0%低于非COPD患者96.7%,差异有统计学意义(P<0.05)。带机>3 d成功脱机患者脱机总时间平均(25.54±27.44)h长于带机<3 d成功脱机患者的(3.92±2.84)h,差异有统计学意义(P<0.05)。结论机械通气患者脱机失败多存在多种因素的共同参与,如带机时间长、营养不良、多器官功能不全、呼吸肌力量不足、心理因素等,增加了脱机的难度,进而出现撤机困难。
Objective To analyze the reasons of offline failure and success of patients with mechanical ventilation and improve the success rate of offline operation. Methods 152 patients with mechanical ventilation (175 cases offline times) were retrospectively analyzed. Results The success rate of taking off machine> 3 days was 87.5% lower than that of carrying machine <3 days, the difference was statistically significant (P <0.05). The success rate of male off-line was 94.9% and 92.2% of female patients, the difference was not statistically significant (P> 0.05). The success rate of offline combination with other organ diseases was 82.9% lower than 96.4% without other organ diseases, the difference was statistically significant (P <0.05). The success rate of off-line in patients with chronic obstructive pulmonary disease (COPD) was 87.0% lower than that of non-COPD patients (96.7%), the difference was statistically significant (P <0.05). The mean total offline time of patients with + 3 d success was (25.54 ± 27.44) h longer than (3.92 ± 2.84) h patients with <3 days of successful offline operation. The difference was statistically significant (P <0.05). Conclusion There are many factors involved in the failure of mechanical ventilation, such as long time with machine, malnutrition, multiple organ dysfunction, lack of respiratory muscle strength, psychological factors and so on, which increases the difficulty of taking off the machine and leads to weaning difficult.