西南医科大学学报2025，Vol.48Issue(1)：87-91,96,6.DOI:10.3969/j.issn.2096-3351.2025.01.017
肺部超声B线评分联合膈肌功能相关参数对重症机械通气患者撤机成功的预测价值
The Predictive Value of Lung Ultrasound B-line Score Combined with Diaphragm Function-Related Parameters for Weaning from Severe Mechanical Ventilation Patients
摘要
Abstract
Objective To explore the predictive value of lung ultrasound B-line score combined with diaphragm function-related parameters for weaning from severe mechanical ventilation patients.Methods A total of one hundred and fifteen critically ill mechanically ventilated patients admitted to our hospital from April 2021 to August 2023 were selected.Patients'readiness for weaning was assessed through lung ultrasonography with a calculated B-line score,and spontaneous breathing trials(SBT)with a T-tube pres-sure support.The indicators of right diaphragmatic excursion and thickness were determined by bedside ultrasound at 30 min of SBT.The diaphragm rapid shallow breathing index,diaphragmatic excursion,and thickness were recorded.Patients were divided into the success group(n=78)and the failure group(n=37)based on their respiratory status 48 hours after weaning.The clinical data were collected,multivariate Logistic regression was used to identify factors affecting the successful weaning in critically ill mechanically ven-tilated patients,and receiver operating characteristic curve(ROC)was plotted to evaluate the predictive value of lung ultrasound B-line score combined with diaphragm function-related parameters for weaning in critically ill mechanically ventilated patients.Results The failure group reported a larger B-line score and diaphragm rapid shallow breathing index,and a smaller changes in diaphragmatic excursion and thickness compared to the success group(P＜0.05).The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ),Sequential Organ Failure Assessment(SOFA)score,respiratory rate,and shallow breathing index were notably higher in the failure group than in the success group,the duration of mechanical ventilation was less than that of the weaning success group(P＜0.05).Logistic regression analysis denoted that lung ultrasound B-line score,diaphragmatic rapid shallow breathing index,right diaphragmatic excursion,diaphragmatic thickness,APACHE-Ⅱ score,SOFA score,respiratory rate,and rapid shallow breathing index were important factors for successful weaning in critically ill mechanically ventilated patients(P＜0.05).ROC curve indicated that the area under the curve(AUC)of combined test of lung ultrasound B-line score,diaphragmatic rapid shallow breathing index,right diaphragmatic excursion,and diaphragmatic thickness for weaning in critically ill mechanically ventilated patients was 0.931,which was larger than separate test(P＜0.05).Conclusion Lung ultrasound B-line score combined with diaphragm function-related parameters has a high predictive value for weaning in critically ill mechanically ventilated patients.关键词
肺部超声B线评分/膈肌超声/重症/机械通气/撤机Key words
Lung ultrasound B-line score/Diaphragm ultrasound/Critically ill/Mechanical ventilation/Weaning分类
医药卫生引用本文复制引用
李梦迪,娄君鸽,张小艳,闫媛媛..肺部超声B线评分联合膈肌功能相关参数对重症机械通气患者撤机成功的预测价值[J].西南医科大学学报,2025,48(1):87-91,96,6.基金项目
河南省高等学校重点科研项目(19A320077) （19A320077）
郑州市医疗卫生领域科技创新指导计划项目(2024YLZDJH256) （2024YLZDJH256）
