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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SaO_2及ΔSaO_2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SaO_2-30、ΔSaO_2差异有统计学意义(P<0.05)。SaO_2-30与拔管成功率显著正相关(P<0.05),ΔSaO_2与拔管成功率显著正相关(P<0.05)。SaO_2-30和ΔSaO_2 ROC下面积分别为0.689、0.733。ΔSaO_2的截断点为0.026(敏感性97.2%,特异性86.4%)。结论:SaO_2下降<2.6%是拔管成功的可靠预测指标,ΔSaO_2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 oxygen saturation and its rate of change on extubation success rate in patients with mechanical ventilation. Methods: A prospective study was conducted to select 63 ICU patients with mechanical ventilation and divided into 2 groups according to extubation results. The differences of SaO 2 and ΔSaO 2 between the two groups were compared. Results: There was no significant difference in gender and age between the two groups (P> 0.05). There were significant differences in SaO_2-30 and ΔSaO_2 between two groups (P <0.05). There was a significant positive correlation between the success rate of extubation and SaO_2-30 (P <0.05), and the positive correlation between ΔSaO_2 and extubation success rate (P <0.05). The areas under SaO_2-30 and ΔSaO_2 ROC were 0.689 and 0.733, respectively. The cut-off point of ΔSaO 2 was 0.026 (97.2% sensitivity and 86.4% specificity). Conclusion: The decrease of SaO_2 <2.6% is a reliable predictor of extubation success. The value of ΔSaO_2 in determining the extubation success rate of patients with mechanical ventilation has certain clinical value.