山东医药2025，Vol.65Issue(5)：86-90,5.DOI:10.3969/j.issn.1002-266X.2025.05.018
膈肌超声参数联合碱剩余在慢性阻塞性肺疾病机械通气患者撤机结果预测中的应用价值
Application value of DU parameters combined with base excess in predicting weaning outcome in mechanically ventilated patients with COPD
摘要
Abstract
Objective To explore the application value of diaphragmatic ultrasound(DU)parameters combined with base excess(BE)in predicting the weaning outcomes of patients with chronic obstructive pulmonary disease(COPD)undergoing mechanical ventilation.Methods Seventy-six COPD patients who received mechanical ventilation treatment were retrospectively included.According to the weaning outcomes of mechanical ventilation,the patients were divided into the successful weaning group(n=50)and failed weaning group(n=26).The color ultrasonic diagnostic in-strument was used to detect the DU parameters[diaphragmatic excursion(DE),diaphragmatic thickening fraction(DTF),diaphragmatic rapid shallow breathing index(D-RSBI),and rapid shallow breathing index(RSBI)]in the two groups,and the blood gas analyzer was used to detect the BE in the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficiency of DU parameters combined with BE for successful weaning in COPD patients.Results Compared with the failed weaning group,the levels of RSBI,D-RSBI and BE in the successful weaning group were lower,while the levels of DE and DTF were higher(all P<0.05).When the cut-off values of RSBI,D-RSBI,DE,DTF and BE were 51.29 events/(min·L),1.82 events/(min·mm),12.17 mm,29.54%,and 2.84 mmol/L,respectively,the Youden indices in predicting successful weaning of COPD patients were 0.438,0.585,0.585,0.485 and 0.769 respectively,the sensitivities were 0.787,0.723,0.816,0.739,0.715,and 0.873,respectively,the speci-ficities were 0.683,0.742,0.786,0.782,and 0.721,respectively,and the area under the curve(AUC)was 0.691,0.836,0.841,0.769,and 0.785,respectively.The Youden index,sensitivity,specificity and AUC of the combined de-tection of DU parameters and BE in predicting successful weaning of COPD patients were 0.447,0.873,0.887,and 0.854,respectively.Compared with RSBI,D-RSBI,DE,DTF and BE,the sensitivity,specificity and AUC of the com-bined detection of DU parameters and BE in predicting successful weaning of COPD patients were all higher(all P<0.05).Conclusion The combination of DU parameters and BE has a high application value in predicting the success or failure of weaning in COPD patients undergoing mechanical ventilation,which can provide a reference for subsequent clinical decision-making.关键词
膈肌超声/膈肌活动度/膈肌增厚分数/膈肌浅快呼吸指数/浅快呼吸指数/碱剩余/慢性阻塞性肺疾病/机械通气Key words
diaphragmatic ultrasound/diaphragmatic excursion/diaphragmatic thickening fraction/diaphragmat-ic rapid shallow breathing index/rapid shallow breathing index/base excess/chronic obstructive pulmonary disease/mechanical ventilation分类
医药卫生引用本文复制引用
王凌峰,陈雄芬..膈肌超声参数联合碱剩余在慢性阻塞性肺疾病机械通气患者撤机结果预测中的应用价值[J].山东医药,2025,65(5):86-90,5.基金项目
广东省医学科学技术研究基金项目(B2024339). （B2024339）
