安徽医科大学学报2016，Vol.51Issue(5)：673-677,5.
膈肌超声预测机械通气撤机结果的价值
The predicting value of diaphragm ultrasound for weaning
摘要
Abstract
Objective To evaluate the predictive performance of the diaphragm thickening fraction( DTF) and the averaged diaphragma excursion( ADE) . Methods 55 patients who received mechanical ventilation over 48 hours and met the criteria for a spontaneous breathing trial were included. The excursion of hemi-diaphragm and the changes of diaphragm thickness were measured by ultrasonography during SBT. The patients were classified into success or failure group according to the weaning outcomes. The receiver operating characteristic curves were calcu-lated to evaluate the predictive performance of each index. Results Diaphragm thickness difference between two groups of patients had no statistical significance ( P=0. 46 ) . 14 subjects ( 27. 5%) had diaphragmatic dysfunction ( DE<10 mm in 11 patients unilaterally and in 3 patients bilaterally) . The AUC of the averaged diaphragm excur-sion( ADE) , the minor diaphragm excursion( MDE) , right DE and left DE to predict the success of weaning were 0. 97,0. 98, 0. 88 and 0. 82, respectively. Optimal cutoff values were 13 mm for the ADE(sensitivity 92%, speci-ficity 99%) , 11 mm for the MDE( sensitivity 90%, specificity 100%) . The cutoff value of DTF>24% was asso-ciated with a successful weaning( sensitivity of 74%, specificity of 79% in right;sensitivity of 84%, specificity of 64% in left) . Conclusion Diaphragm ultrasound is feasible to predict the outcome of the weaning. The ADE and MDE may be accurate parameters to predict weaning outcomes.关键词
膈肌/超声/脱机/膈肌功能障碍Key words
diaphragm/ultrasonography/weaning/diaphragmatic dysfunction分类
医药卫生引用本文复制引用
胡仕静,周树生,吴丹,刘宝..膈肌超声预测机械通气撤机结果的价值[J].安徽医科大学学报,2016,51(5):673-677,5.基金项目
安徽省卫生厅医学科研基金(编号:13zc044) （编号:13zc044）
