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頁籤選單縮合
題名 | 呼吸道阻塞是神經外科病人手術後脫離呼吸器的重要預測因子=Airway Obstruction Is an Important Predictive Factor for Weaning in Postoperative Patients of Neurosurgical Diseases |
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作者 | 鄭愛琴; 林泱瀚; 劉忠鋒; 柯獻欽; 郭進榮; 陳欽明; 周偉倪; | 書刊名 | 台灣急重症醫學雜誌 |
卷期 | 8:4 2023.12[民112.12] |
頁次 | 頁104-111 |
分類號 | 415.41 |
關鍵詞 | 呼吸道阻塞; 神經外科手術; 呼吸器脫離; 預測因子; 機械通氣; Airway obstruction; Neurosurgery; Weaning; Predictive factor; Mechanical ventilation; |
語文 | 中文(Chinese) |
中文摘要 | 目的:神經外科手術後病人會因意識變化及咳痰功能減弱等因素,導致需要較多時間脫離呼吸器。本研究旨在評估接受神經外科手術病人脫離呼吸器的預測因素。 方法:我們在 2019 年 1 月至 12 月期間,在臺灣南部某醫療中心的加護病房接受機械通氣的神經外科手術後病人進行一項回顧性研究。我們比較年齡、性別、體重指數、接受機械通氣原因、慢性共病、急性生理和慢性健康評估系統 (APACHE II) 和格拉斯哥昏迷分數(GCS)等各種因素在呼吸器脫離成功組和脫離失敗組之間的差異。成功呼吸器脫離被定義為 72 小時內不需要機械通氣。我們採用邏輯回歸分析來確定與脫離失敗相關的風險因素。成功脫離呼吸器的預測模型被呈現為圖表,以檢測困難脫離的風險因素及相應的死亡率。分析使用 SPSS 26 版本進行,P 值 <0.05 被認為具有統計學意義。 結果:在研究期間,共納 319 名接受機械通氣的神經外科手術後病人,其中 310 名(97.2%)病人成功脫離呼吸器。我們利用多變量邏輯回歸來預測呼吸器脫離的結果,並進行脫離失敗風險因素的分析。結果顯示因呼吸道阻塞需接受機械通氣病人,成功脫離比率顯著下降(7.1% vs. 55.6%,勝算比 = 15.867,95% CI = 3.343 - 75.326,p 值 = 0.0001)。 結論:呼吸道阻塞為神經外科手術後病人接受機械通氣後呼吸器脫離失敗潛在因素。 |
英文摘要 | Purpose: Patients undergoing neurosurgery may need additional time for weaning from mechanical ventilation due to factors as drowsy consciousness and compromised cough reflex. This study aims to evaluate the predictive factors of weaning mechanical ventilation in postoperative neurosurgical patients. Methods: We conducted a retrospective study on neurosurgery patients who underwent mechanical ventilation in the intensive care units of a medical center located in southern Taiwan from January to December 2019. We compared various factors such as age, gender, body mass index, reasons for mechanical ventilation, chronic comorbidities, APACHE II scores, and Glasgow Coma Scale (GCS) scores between patients in the weaning success and weaning failure groups. Successful weaning from ventilator was defined as not requiring mechanical ventilation for over 72 hours. Logistic regression analyses were employed to identify the risk factors associated with weaning failure. Prediction models of successful weaning were presented as nomograms to detect the risk factors responsible for difficult weaning and the corresponding mortality rates. The analysis was performed using SPSS version 26, with a P-value < 0.05 was considered statistically significant. Results: Throughout the study period, a total of 319 neurosurgery patients who underwent mechanical ventilation were included, of which 310 (97.2%) patients achieved successful weaning. A multivariate logistic regression model was developed to predict the outcomes of weaning, and an analysis of risk factors for weaning failure was conducted. The findings indicated that patients who underwent mechanical ventilation due to airway obstruction exhibited significantly lower rates of successful weaning (7.1% vs. 55.6%, odds ratio = 15.867, 95% CI = 3.343 - 75.326, p-value = 0.0001). Conclusion: Airway obstruction has been recognized as a potential factor for weaning failure in neurosurgery patients who underwent mechanical ventilation |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。