摘要
Abstract
Objective:To study and analyze the predictive value of bedside ultrasound diaphragm function assessment for mechanical ventilation withdrawal in chronic obstructive pulmonary disease(COPD).Method:A total of 60 patients who underwent mechanical ventilation in the First People's Hospital of Liangshan Yi Autonomous Prefecture from April 2022 to June 2023 were selected as the research objects,and 2 h spontaneous breathing test(SBT)was performed after meeting the clinical weaning conditions.After the end of the trial,the patients were evaluated by bedside ultrasound.According to the results of weaning,the patients were divided into the reference group(weaning failure,n=28)and the experimental group(weaning success,n=32).The relevant parameters of bedside ultrasound diaphragmatic function evaluation such as diaphragmatic thickness at the end of inspiration(DTei),diaphragmaticthickness at the end of expiration(DTee),diaphragmatic thickening fraction(DTF),diaphragmatic displacement(DD),rapid shallow breathing index(RSBI)and diaphragmatic rapid shallow breathing index(D-RSBI)were compared between two groups after 30 min of SBT.The receiver operating characteristic curve(ROC)was used to analyze the application efficiency of bedside ultrasound function evaluation related parameters in weaning guidance of COPD patients with mechanical ventilation.Result:There were no statistically significant differences in DTei and DTee between two groups after 30 min of SBT(P>0.05);the DTF of the experimental group after 30 min of SBT was higher than that of the reference group,and the DD was longer than that of the reference group,the differences were statistically significant(P<0.05).The RSBI and D-RSBI of the experimental group after 30 min of SBT were lower than those of the reference group,and the differences were statistically significant(P<0.05).When the area under the curve(AUC)≥0.7,it indicated that the predictive value was good.DTF,DD,RSBI and D-RSBI all had good predictive value for weaning,and their AUC were 0.840,0.749,0.876 and 0.804,respectively;at the same time,the sensitivity of DTF was higher than those of DD,RSBI and D-RSBI.Conclusion:The parameters of DTF,RSBI and D-RSBI obtained by bedside ultrasound diaphragmatic function assessment have good application efficacy in the guidance of COPD weaning,which can provide good predictive value for clinical successful weaning.关键词
床旁超声/膈肌功能/慢性阻塞性肺疾病/机械通气Key words
Bedside ultrasound/Diaphragm function/Chronic obstructive pulmonary disease/Mechanical ventilation
