摘要目的 探讨自行设计的机械通气脱机拔管核查单应用于机械通气患者脱机拔管前的评估，以降低气管插管机拔管后48 h 内再插管率。方法 选取2017年7月～2018年6月我院使用机械通气脱机拔管核查单的386 例机械通气脱机拔管患者作为研究组，选取我院2016年7月～2017年6月未使用机械通气脱机拔管核查单的372 例患者作为对照组。比较两组患者气管插管拔管后48 h 内再插管率及机械通气时间。结果 研究组患者的气管插管拔管后48 h 内再插管率为1.55%，低于对照组的6.45%，差异有统计学意义（P<0.05）。两组患者的机械通气时间比较，差异无统计学意义（P>0.05）。结论 应用机械通气脱机拔管核查单能提高ICU 医生对机械通气脱机、拔管指征的评估能力，能有效降低气管插管拔管后48 h 内再插管率，保证患者安全，临床值得推广。
Abstract：Objective To investigate the self-designed mechanical ventilation offline extubation checklist for the evaluation of mechanical ventilation patients before offline extubation, so as to reduce the re-intubation rate within 48 hours after extubation of tracheal intubation machine.Methods A total of 386 patients with mechanical ventilation offline extubation using the checklist from July 2017 to June 2018 were selected as study group, and another 372 patients who didn′t adopt the mechanical ventilation offline extubation checklist from July 2016 to June 2017 was selected as control group.The re-intubation rate within 48 hours after extubation of tracheal intubation and mechanical ventilation time were compared in the two groups.Results The re-intubation rate within 48 hours after extubation of tracheal intubation in the study group was 1.55%, which was lower than that in the control group accounting for 6.45%, and the difference was statistically significant (P<0.05).There was no significant difference in the mechanical ventilation time between the two groups (P>0.05).Conclusion The application of mechanical ventilation offline extubation checklist can improve the ability of ICU doctors to evaluate the mechanical ventilation off-line and extubation indications, and can effectively reduce the rate of re-intubation within 48 hours after extubation to ensure safety of patients, which is worthy of promotion.
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