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目的研究不同因素对左向右分流型先心病新生儿呼吸机撤离(简称撤机)成功率的影响。方法收集左向右分流型先心病机械通气新生儿95例,定义48 h内无需重新插管者属撤机成功。以撤机成功率为因变量,以新生儿胎龄、体重、肺动脉压力水平、肺血流量、缺损大小、缺损类型、合并心衰、肺炎为自变量进行多元线性逐步回归,筛选出可能的影响因素,进一步研究不同影响因素对撤机成功率的影响。结果肺动脉压力、肺血流量大小和缺损类型是影响撤机成功率的重要因素(P均<0．05)。中重度肺动脉高压组的撤机成功率低于轻度肺动脉高压组(P均<0．05),差异有统计学意义。高肺血流量组的撤机成功率低于无高肺血流量组(P均<0．05),差异有统计学意义。联合缺损组的撤机成功率低于单纯缺损组(P均<0．05),差异有统计学意义。结论肺动脉压、肺血流量、缺损类型是影响撤机成功率的重要因素。
Objective To study the effect of different factors on the success rate of neonatal ventilator evacuation (referred to as weaning) in left-to-right shunt congenital heart disease. Methods Ninety-five neonates with mechanical ventilation of left-to-right shunt congenital heart disease were collected. The success rate of weaning was taken as the dependent variable. The multiple linear stepwise regression was carried out by multiple linear stepwise regression with gestational age, weight, pulmonary arterial pressure, pulmonary blood flow, defect size, defect type, heart failure and pneumonia as independent variables Factors, to further study the impact of different factors on the success rate of weaning. Results Pulmonary artery pressure, pulmonary blood flow and defect types were the important factors affecting the success rate of weaning (P <0.05). The success rate of weaning in moderate-severe pulmonary hypertension group was lower than that in mild pulmonary hypertension group (all P <0.05), the difference was statistically significant. The success rate of weaning in high pulmonary blood flow group was lower than that of non-high pulmonary blood flow group (all P <0.05), the difference was statistically significant. The success rate of weaning in combined defect group was lower than that in simple defect group (all P <0.05), the difference was statistically significant. Conclusions Pulmonary artery pressure, pulmonary blood flow and defect types are important factors that influence the success rate of weaning.