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ID:5283353
大小:3.44 MB
页数:25页
时间:2017-12-07
《呼吸机撤离的方法及影响因素临床分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、山西医科大学硕士学位论文呼吸机撤离的方法及影响因素临床分析姓名:王飞申请学位级别:硕士专业:呼吸内科学指导教师:张新日20080415【lJ州医科人学硕J:学位沦文呼吸机撤离的方法及影响因素临床分析摘要目的分析影响呼吸机撤离的相关因素,寻找影响呼吸机撤离成败的关键性环节,提出针对性的解决措施,为临床撤机实践提供理论指导。方法收集我院近5年来行机械通气治疗患者的临床资料,整理归类后进行统计学分析。结果单因素logistic回归分析结果表明:年龄、性别等26项因素对撤机过程有影响。多因素logistic回归分析结果表明:肺部感染、腹胀、A
2、PACHEII评分是影响撤机的独立危险因素;强有力的咳嗽排痰能力是撤机过程唯一的有利因素。从撤机方式来看,SBT撤机方式成功率最高,其次为有创.无创序贯通气,而直接撤机方式成功率最低。结论基础疾病的种类和严重程度对机械通气患者的预后影响很大。肺部感染、腹胀和APACHEII评分是影响撤机成败的独立危险因素,患者自主咳嗽及排痰能力是撤机过程的唯一保护性因素。采用SBT方式撤机,可提高撤机成功率。关键词呼吸机,撤机,影响因素————————————————~.一坐些丝壁查兰竺!:兰丝笙兰Clinicalapproachofweaninga
3、nditsinfluencefactorsAbstractObjectiveTofindoutthekeylinkinfluencingweaningresultandthesolutionforthatandpreferpracticeguidelinesforweaningbyanalysingmanyfactorsinfluencingthewholeweaningprocess.MethodsTheclinicaldataof140patientswithmechanicalventilationinourhospitalov
4、erthelastfiveyearswerecollectedandanalyzed.ResultsUnivariatelogisticregressionanalysisshowedthat26factors(includingage,genderandSOon)influencedweaning.Multivariatelogisticregressionanalysisshowedthatpulmonaryinfection,abdominaldistensionandAPACHEIIscorewereindependentri
5、skfactorsinfluencingweaning,whiletheeffectiveabifityofcoughandspitwasthesoleadvantageousfactorinfluencingweaning.Intermsofusualweaningways,theachievementratioofSBTwasthetopmost,followedbythewayofsequentialnon.invasivefollowingshort.tenninvasivemechanicalventilation,whil
6、etheachievementratioofdirectweaningwayWasthelowest.ConclusionUnivariatelogisticregressionanalysisshowedthat26factors(includingage,genderandSOon)influencedweaning.Multivariatelogisticregressionanalysisshowedthatpulmonaryinfection,abdominaldistensionandAPACHEIIscorewerein
7、dependentriskfactorsinfluencingweaning,whiletheeffectiveabilityofcoughandspitwastheonlyadvantageousfactorinfluencingweaning.Intermsofusualweaningways,theachievementratioofSBT、vasthetopmost,followedbythewayofsequentialnon.invasivefollowingshort.tenninvasivemechanicalvent
8、ilation,whiletheachievementratioofdirectweaningwaywasthelo、vest.Keywordsventilator,weaning,influencefactor学位论文
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