長期使用呼吸器

Long Term Mechanical Ventilation

李俊德(Jiunn-Der Lee) ； 陳寶貝(Pao-Pei Chen) ； 林碧華(Bi-Hwa Lin)

《呼吸治療》 2卷1期 (2003/01) Pp. 21-26

https://doi.org/10.6269/JRT.2003.2.1.04

摘要

長期使用呼吸器定義為使用呼吸器超過卅天者，為了明瞭這些病患在醫學中心的發生機率、好發族群、病患預後等流行病學資料，自千禧年1月1日至12月31日止，我們追蹤符合條件的病患，再與同時期內全院使用呼吸器病患數據相比較，並往前追溯這些病患的臨床資料，依預後分成在院內成功脫離及無法脫離呼吸器二組，比較彼此間有何差異。結果顯示：一.高榮全年的呼吸器使用中，11.3%（320/2835）的病患為長期使用呼吸器，平均使用呼吸器60±40天，住院82±58天，其中216人（67.5%）接受氣切管手術。二.呼吸器一般使用以手術後的外科病患為主，而神經肌肉病變、慢性胸腔疾病及感染失控等是造成病患成為長期使用呼吸器的最大原因。三.長期使用呼吸器的病患在本院內有35%（113/320）成功脫離呼吸器，追蹤轉院後的病患又有24%（21/86）脫離呼吸器。四.比較長期使用呼吸器病患在院成功脫離及無法脫離呼吸器二組，在性別、平均住院日數、是否接受氣切管手術及插管後氣切日數均無大差別，但在年齡及使用呼吸器日數上則有顯著不同。五.長期使用呼吸器病患於使用呼吸器卅天時，臨床資料包括氧氣分率、白血球數、血尿素氮、血清肌酸酐及總膽紅素量在成功脫離呼吸器組較低，而血色素、血小板數及白蛋白值則比無法脫離呼吸器組為高。（呼吸治療2003;1(1):21～26）

關鍵字

長期使用呼吸器 ； 脫離呼吸器

並列摘要

Long term mechanical ventilation (LTMV) was defined as the patients requiring mechanical ventilation over 30 days. For the epidemiological data of LTMV in a medical center, we prospectively followed patients fulfilling the criteria from 2000-1-1 to 12-31, and retrospectively examined the clinical data of these patients during hospitalization. The results were: 1. 11.3% (320/2835) patients were LTMV in Kaohsiung Veterans General Hospital with mean mechanically ventilated days 60±40, mean admission days 82±58 and 216 (67.5%) patients received tracheostomy. 2. The majority of common ventilator users were surgical patients who required mechanical ventilation for post-operative care, but the causes of LTMV were neuromuscular disorder, chronic pulmonary disease and uncontrolled infection. 3. 35% (113/320) LTMV patients were weaned from ventilator successfully at our hospital and another 24% (21/86) patients were discontinued from ventilator after transferring to other hospital during follow-up period. 4. Comparing the weaning and un-weaning group of LTMV, there was no difference in gender, mean admission days, receiving tracheostomy or not and the days of tracheostomy post endotracheal intubation, but significant statistically difference was shown in age and mean ventilation days. 5.LTMV patients had lower FiO2, WBC, BUN, creatinine, total bilirubin, and higher hemoglobin, platelet, albumin data in weaning group as comparing with un-weaning group when the 30th day of mechanical ventilation.

並列關鍵字

Long term mechanical ventilation ； Weaning of ventilator