巴楚医学2025，Vol.8Issue(2)：30-36,7.DOI:10.3969/j.issn.2096-6113.2025.02.005
体外膈肌起搏器在重症肺炎机械通气患者中的应用效果及撤机失败的影响因素分析
Application Effect of Extracorporeal Diaphragm Pacemaker in Patients with Severe Pneumonia Undergoing Mechanical Ventilation and Influencing Factors of Evacuation Failure
摘要
Abstract
Objective:To explore the application effect of external diaphragm pacemaker in patients with severe pneumonia undergoing mechanical ventilation and discuss the influencing factors of ventilator evacuation failure.Methods:A total of 100 patients with severe pneumonia who received mechanical ventilation treatment at Yichang Central People's Hospital from January 2023 to October 2023 were enrolled.According to whether the external diaphragm pacemaker was used for treatment,the patients were divided into the control group(n=50)and the treatment group(n=50),and the therapeutic effects of the two groups of patients were compared.Further grouping was conducted based on whether the ventilator weaning was successful.Univariate and multivariate Logistic regression analyses were used to analyze the independent influencing factors of ventilator weaning failure.Results:The diaphragmatic mobility[(1.47±0.17)cm vs(1.34±0.15)cm],diaphragmatic thickening rate[(38.64±6.37)％vs(29.68±5.61)％],and weaning success rate(88.00％vs 72.00％)were significantly higher in the treatment group than in the control group,while the duration of mechanical ventilation[(17.14±5.24)d vs(21.92±4.85)d],ICU hospital stay[(19.80±5.55)d vs(24.24±5.88)d],and mortality within 28 days(8.00％vs 24.00％)were significantly lower in the treatment group(all P＜0.05).Multivariate analysis results showed that age(OR=1.129,95％CI:1.018,1.254),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score(OR=1.272,95％CI:1.097,1.406),oxygenation(P/F)index(OR=0.971,95％CI:0.949,0.994),diaphragmatic mobility before treatment(OR=0.002,95％CI:0.000,0.645),and diaphragmatic mobility after treatment(OR=0.046,95％CI:0.006,0.340)were independent influencing factors of evacuation failure.Conclusion:External diaphragm pacemakers can effectively improve the treatment effects of patients with severe pneumonia.Age,APACHE Ⅱ score,P/F index,diaphragmatic mobility before treatment,and diaphragmatic mobility after treatment are independent influencing factors of ventilator evacuation failure.关键词
体外膈肌起搏器/重症肺炎/机械通气/呼吸机撤离失败Key words
extracorporeal diaphragm pacemaker/severe pneumonia/mechanical ventilation/evacuation failure分类
临床医学引用本文复制引用
王巍,万晓蓉,吴苒苒,吴迪,张青..体外膈肌起搏器在重症肺炎机械通气患者中的应用效果及撤机失败的影响因素分析[J].巴楚医学,2025,8(2):30-36,7.基金项目
国家自然科学基金项目(82300039) （82300039）
