PtcO₂ 和 PtcCO₂ 及呼吸力学参数对呼吸衰竭病人有创通气撤机预测价值

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[中图分类号] R563.8；R446.112 [文献标志码］A [文章编号] 2096-5532（2025）04-0573-05

doi：10.11712/jms.2096-5532.2025.61.133

[Abstract] ObjectiveTo investigate the value of transcutaneous partial pressure of oxygen （ Ptc2 ），transcutaneous partial pressure of carbon dioxide （ PtcCO2 ），and respiratory mechanics parameters in predicting invasive ventilator weaning in patients withrespiratoryfailure.MethodsAtotalof185patientswithrespiratoryfilurewhowereadmitedtoourhospitalfromOcto ber 2023to September2024wereenroledanddividedintosucesful groupwith150patientsandfailedgroupwith35patientsaccording to the status of ventilator weaning. The value of PtcO2 ， PtcCO2 ，and respiratory mechanics parameters in predicting the failureofinvasiveventilatorweaning inpatientswithrespiratoryfailurewasanalyzed.ResultsThereweresignificantdierences between the two groups in underlying diseases，Acute Physiology and Chronic Health Evaluation I score，the length of stay in the intensive care unit，airway oclusion pressure at O.1 second （Po.1），rapid shallow breathing index （RSBI）， Ptc2 at 6and 12h after ventilation，and PtcCO2 at 12h after ventilation （t=2.784-8.595，χ2=17.433，P<0.05） . The presence of underlying diseases，PO.1，RSBI， PtcO2 at6and 12h after ventilation，and PtcCO2 at 12h after ventilation were independent influencing factors for the failure of invasive ventilator weaning in patients with respiratory failure （ P<0.05） .P0.1，RSBI， PtcO2 at 6h after ventilation， PtcO2 at 12h after ventilation，and PtcCO2 at 12h after ventilation had an area under the ROC curve（AUC）of 0.746， 0.798，0.816，O.830，andO.668，respectively，inpredictingthefailureofinvasiveventilatorweaninginpatientswithrespatory failure，and the combination of these five parameters had an AUC of O.996，with a sensitivity of 97.1% and a specificity of 100.0% Conclusion The combination of Ptc2 ， PtcCO2 ，and respiratory mechanics parameters has a relatively high value in predicting the failure of invasive ventilator weaning in patients with respiratory failure.

[Key words]respiratory insuficiency；blood gasmonitoring，transcutaneous；respiratory mechanics；ventilators，negativepressure； forecasting

呼吸衰竭的治疗关键在于确保有效的通气与氧合。（剩余6934字）