摘要：目的 将自主呼吸试验(SBT)与同步间歇指令通气(SIMV)逐步撤机法的机械通气患者进行比较,以寻找最佳撤机方式.方法 将126例机械通气患者随机分为SBT组和对照组,观察两组患者的平均机械通气时间、入住ICU时间、呼吸机相关肺炎(VAP)发生率、48 h内再插管率,应用SPSS13.0软件进行统计学分析.结果 SBT组与对照组平均机械通气时间分别为(3.9±1.9)d和(5.6±2.2)d,平均入住ICU时间分别为(5.5±2.4)d和(7.4±3.0)d,VAP发生率分别为11.3%和26.6%,48 h内再插管率分别为9.7%和10.9%.结论 SBT撤机方式比SIMV逐步撤机法具有机械通气时间短、住ICU时间短,VAP发生率低的优点,而48 h内再插管率差异无统计学意义,体现了SBT应用于撤机过程中的优越性. Abstract： Objective To find a reasonable weaning way through comparing mechanical ventilation patients treated by spontaneous breathing trials(SBT)with those treated by SIMV gradual weaning. Methods One hundred and twenty six mechanical ventilation patients were divided into SBT group and control group (SIMV group) ,then the average duration of mechanical ventilation,the average time in ICU,the ventilator associated pneumonia(VAP)rate as well as the re -intubation rate within 48 hours were recorded,and finally SPSS 13. 0 was used to make statistical analysis. Results The average mechanical ventilation duration of SBT group and control group were (3.9 ± 1.9) days and (5. 6 ± 2. 2) days respectively, the average time in ICU were (5. 5 ±2. 4) days and (7. 4 ±3. 0) days respectively,the VAP rate was 11.3% and 26. 6 % respectively and the re-intubation rate within 48 hours was 9. 7% and 10. 9% respectively. Conclusions SBT weaning is superior to SIMV gradual weaning in short duration of mechanical ventilation,short time in ICU and low VAP rate. And there is no statistically significant difference in the re -intubation rate within 48 hours.