[1]王金娜,张国倩,毋利强,等.呼气末二氧化碳分压、膈肌收缩速度、膈肌浅快呼吸指数与脓毒症患者机械通气撤机结局关系研究[J].陕西医学杂志,2025,54(11):1485-1489.[doi:DOI:10.3969/j.issn.1000-7377.2025.11.008]
　WANG Jinna,ZHANG Guoqian,WU Liqiang,et al.Relationship between end-tidal carbon dioxide partial pressure,diaphragmatic contraction velocity,Diaphragmatic Rapid Shallow Breathing Index and the outcome of mechanical ventilation weaning in sepsis patients[J].,2025,54(11):1485-1489.[doi:DOI:10.3969/j.issn.1000-7377.2025.11.008]
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呼气末二氧化碳分压、膈肌收缩速度、膈肌浅快呼吸指数与脓毒症患者机械通气撤机结局关系研究

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年11期
页码:
1485-1489
栏目:
临床研究
出版日期:
2025-11-05

文章信息/Info

Title:
Relationship between end-tidal carbon dioxide partial pressure,diaphragmatic contraction velocity,Diaphragmatic Rapid Shallow Breathing Index and the outcome of mechanical ventilation weaning in sepsis patients
作者:
王金娜; 张国倩; 毋利强; 王芬; 曲云云; 陈旭萍; 祁林
（山西医科大学附属运城市中心医院重症医学科，山西 运城 044000）
Author(s):
WANG Jinna; ZHANG Guoqian; WU Liqiang; WANG Fen; QU Yunyun; CHEN Xuping; QI Lin
(Department of Critical Care Medicine,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,China)
关键词:
脓毒症; 呼气末二氧化碳分压; 膈肌收缩速度; 膈肌浅快呼吸指数; 机械通气; 撤机; 预测价值
Keywords:
Sepsis; End-tidal carbon dioxide partial pressure; Diaphragmatic contraction velocity; Diaphragmatic Rapid Shallow Breathing Index; Mechanical ventilation; Weaning; Predictive value
分类号:
R 631
DOI:
DOI:10.3969/j.issn.1000-7377.2025.11.008
文献标志码:
A
摘要:
目的：探讨呼气末二氧化碳分压（PetCO2）、膈肌收缩速度、膈肌浅快呼吸指数（D-RSBI）与脓毒症患者机械通气（MV）撤机结局的关系。方法：选取给予MV治疗的脓毒症患者80例，根据撤机结局将患者分为撤机失败组（29例）和撤机成功组（51例）。比较两组患者PetCO2、D-RSBI指数及自主呼吸试验（SBT）前后膈肌收缩速度。采用多因素Logistic回归分析脓毒症患者MV撤机失败的影响因素。绘制受试者工作特征曲线（ROC）分析PetCO2、D-RSBI指数、SBT前膈肌收缩速度对脓毒症患者MV撤机失败的预测价值。结果：与撤机成功组比较，撤机失败组患者MV时间、急性生理学与慢性健康状况评估Ⅱ（APACHEⅡ）、序贯器官衰竭（SOFA）评分、呼吸频率（RR）、SBT前心率及脓毒症休克比例升高，氧合指数降低（均P＜0.05）。与撤机成功组比较，撤机失败组SBT前PetCO2、D-RSBI指数较高（均P<0.05）。与撤机失败组比较，撤机成功组SBT前后膈肌收缩速度升高（均P<0.05）。机械通气时间、脓毒症严重程度、SBT前膈肌收缩速度、D-RSBI指数、PetCO2为脓毒症患者MV撤机失败的独立影响因素（均P<0.05）。PetCO2、D-RSBI指数、SBT前膈肌收缩速度联合预测脓毒症患者MV撤机失败的曲线下面积（AUC）高于三者单独预测的AUC（均P＜0.05）。结论：PetCO2、膈肌收缩速度、D-RSBI指数与脓毒症患者MV撤机结局有关，且联合检测对脓毒症患者MV撤机失败具有一定预测价值。
Abstract:
Objective:To investigate the relationship between end-tidal carbon dioxide partial pressure (PetCO2),diaphragmatic contraction velocity,Diaphragmatic Rapid Shallow Breathing Index (D-RSBI),and the outcome of mechanical ventilation (MV) weaning in sepsis patients.Methods：A total of 80 sepsis patients who received MV treatment were selected and divided into two groups based on the outcome of weaning:the weaning failure group (29 cases) and the weaning success group (51 cases).The study compared PetCO2,D-RSBI index,and diaphragmatic contraction velocity before and after spontaneous breathing trial (SBT) between the two groups.Multivariate logistic regression analysis was used to identify factors influencing MV weaning failure in sepsis patients.ROC curves were plotted to analyze the predictive value of PetCO2,D-RSBI index,and diaphragmatic contraction velocity before SBT for MV weaning failure in sepsis patients.Results:Compared with the weaning success group,the weaning failure group had longer MV duration,higher APACHEⅡscore,higher SOFA score,higher respiratory rate (RR),higher heart rate before SBT,higher proportion of septic shock,and lower oxygenation index (all P<0.05).The weaning failure group also had higher PetCO2 and D-RSBI index before SBT (all P<0.05).Diaphragmatic contraction velocity before and after SBT was higher in the weaning success group (all P<0.05).MV duration,severity of sepsis,diaphragmatic contraction velocity before SBT,D-RSBI index and PetCO2 were independent influencing factors for MV weaning failure in sepsis patients (all P<0.05).The AUC for predicting MV weaning failure in sepsis patients using the combination of PetCO2,D-RSBI index,and diaphragmatic contraction velocity before SBT was higher than that of each factor alone (all P<0.05).Conclusion:PetCO2,diaphragmatic contraction velocity and D-RSBI index are associated with the outcome of MV weaning in sepsis patients,and combined detection has certain predictive value for MV weaning failure in sepsis patients.

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备注/Memo

备注/Memo:
山西省重点研发计划项目（2024SXZD12316）
更新日期/Last Update: 2025-11-04