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李 莘 潘慧斌 姜 燕 邹晓月▲ 包 芸.标准化流程撤机智能软件在慢性阻塞性肺疾病急性加重机械通气患者撤机中的应用效果[J].中国现代医生,2021,59(11):6-9
标准化流程撤机智能软件在慢性阻塞性肺疾病急性加重机械通气患者撤机中的应用效果
The application effect of standard process weaning intelligent software in weaning patients with acute exacerbation of chronic obstructive pulmonary disease with mechanical ventilation
  
DOI:
中文关键词:  慢性阻塞性肺疾病  呼吸衰竭  机械通气  呼吸机撤机  舒适度
英文关键词:Chronic obstructive pulmonary disease  Respiratory failure  Mechanical ventilation  Ventilator weaning  Comfort
基金项目:浙江省医药卫生科技计划项目(2018KY776);浙江省湖州市科技局公益性技术应用研究(一般)项目(2018 GYB55)
作者单位
李 莘 潘慧斌 姜 燕 邹晓月▲ 包 芸 浙江省湖州市第一人民医院急诊医学科浙江湖州 313000 
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中文摘要:
      目的 探讨标准化流程撤机智能软件在慢性阻塞性肺疾病急性发作(AECOPD)机械通气患者撤机中的应用效果。方法 选取2018 年6 月至2019 年6 月入住我院EICU 的68 例AECOPD 机械通气患者,按照智能软件使用时间将患者分成两组,其中将2018 年6—12 月根据医生经验主导撤机的32 例患者设为对照组,另将2019年1—6 月采用标准化流程智能软件撤机的36 例患者设为观察组,比较两组患者机械通气时间、撤机成功率、呼吸机相关性肺炎(VAP)发生率、住院时间、住院费用、患者舒适度情况。结果 ①两组患者入组时的一般资料、GCS 评分以及危重症评分等比较,差异无统计学意义(P>0.05);②观察组机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05);观察组VAP 发生率及住院费用均低于对照组,差异有统计学意义(P<0.05);而撤机成功率则高于对照组,差异有统计学意义(P<0.05)。③观察组患者的舒适度评分显著优于对照组,差异有统计学意义(P<0.05)。结论 标准化流程撤机智能软件能规范AECOPD 机械通气过程,系统评估患者病情,及时撤机,同时给予相应的撤机后序贯治疗,有助于机械通气患者的疾病转归及预后,提高患者住院期间的舒适度,改善护理结局,减少患者住院时间及费用,提高患者的生存质量,值得临床推广。
英文摘要:
      Objective To investigate the application efficacy of standard process weaning intelligent software in weaning patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with mechanical ventilation.Methods A total of 68 patients with AECOPD who were admitted to EICU of our hospital from June 2018 to June 2019 were selected and divided into two groups according to the application time of intelligent software.Among them,patients who took the doctor′s advice in weaning from June to December 2018 were included into the control group(n=32),and those who took the standard process of intelligent software in weaning from January to June 2019 were included into the observation group (n=36).Mechanical ventilation time,weaning success rate,incidence of ventilator-associated pneumonia (VAP),hospitalization days,hospitalization expenses and comfort of patients were compared between the two groups.Results ①There were no significant differences in general data,GCS score and critical illness score between the two groups of patients (P>0.05).②The mechanical ventilation time and the hospitalization days were shorter than those in the control group,with statistically significant differences (P<0.05).The VAP incidence and hospitalization expenses in the observation group were both lower than those in the control group,with statistically significant differences(P<0.05).While the success rate of weaning in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).③The comfort score in the observation group was better than that in the control group,with statistically significant differences(P<0.05).Conclusion Standard process weaning intelligent software can standardize the mechanical ventilation process of AECOPD,systematically evaluate the patient′s condition,wean the patient in time,and give corresponding sequential treatment after weaning,which is helpful to the disease outcome and prognosis of patients with mechanical ventilation,improve the comfort of patients during hospitalization,improve the nursing outcome,reduce the hospitalization time and expenses of patients,and raise the quality of life of patients.Therefore,it is worthy of clinical promotion.
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