结核与肺部疾病杂志2026，Vol.7Issue(3)：308-313,6.DOI:10.19983/j.issn.2096-8493.20260082
护士主导的程序化撤机在重症监护室有创机械通气患者中的应用效果评价
Evaluation of the application effect of nurse-led protocol-based weaning in patients with invasive mechanical ventilation in the intensive care unit
摘要
Abstract
Objective:To compare the application effects of a nurse-led protocolized weaning program with conventional weaning program in intensive care unit(ICU)patients receiving invasive mechanical ventilation,and to provide evidence for clinical weaning practice.Methods:A total of 120 patients receiving invasive mechanical ventilation and admitted to the Emergency ICU and Surgical ICU of Qingpu Hospital Affiliated to Fudan University from January to September 2025 were enrolled and divided into an observation group and a control group,with 60 cases in each group.The control group received conventional weaning,while the observation group received a nurse-led protocolized nursing program(including daily weaning screening,3-minute spontaneous breathing trial,spontaneous breathing trial,physician-nurse collaborative weaning and extubation,and post-extubation nursing management and monitoring).The daily weaning screening rate,mean duration of mechanical ventilation,weaning failure rate,and ICU length of stay were compared between the two groups.Results:The median(Q1,Q3)daily weaning screening rate in the observation group was 100.0％(100.0％,100.0％),which was higher than that in the control group(66.7％(50.0％,75.0％)).The duration of mechanical ventilation in the observation group was(73.4±24.8)h,shorter than that in the control group((82.2±23.1)h).The ICU length of stay in the observation group was(4.9±1.4)d,shorter than that in the control group((5.8±1.6)d).All differences were statistically significant(Z=9.222,P＜0.001;t=1.999,P=0.048;t=3.305,P=0.001).The weaning failure rate was 1.7％(1/60)in the observation group and 3.3％(2/60)in the control group,with no statistically significant difference(x2=0.342,P=0.559).Conclusion:The nurse-led protocolized weaning can shorten the weaning time,mean duration of mechanical ventilation,and ICU length of stay in patients receiving invasive mechanical ventilation,but has no effect on the weaning failure rate.Overall,it has clinical application value.关键词
护士/通气机,机械/对比研究Key words
Nurses/Ventilators,mechanical/Comparative study分类
医药卫生引用本文复制引用
夏丽芳,范志文,张惟,金伟魏..护士主导的程序化撤机在重症监护室有创机械通气患者中的应用效果评价[J].结核与肺部疾病杂志,2026,7(3):308-313,6.基金项目
复旦大学复星护理科研基金(FNF202453) Fuxing Nursing Research Fund of Fudan University(FNF202453) （FNF202453）
