目的：调查分析神经外科重症患者气管插管计划拔管失败的相关影响因素。方法：收集我科重症监护 室进行气管插管、带管时间＞48 h、进行过气管插管拔管操作的患者的临床资料及与拔管结果相关的影响因 素，比较拔管成功组与失败组之间因素的差异，分析其危险因素。结果：共收集病例108例，拔管失败19例， 成功89例。2组格拉斯哥昏迷量表（GCS）评分、机械通气时间、呼吸浅快指数、咳嗽反射差异有统计学意义 （P＜0.05）。结论：GCS评分、机械通气时间、呼吸浅快指数及咳嗽反射可能是影响气管插管计划拔管成败 的重要因素。

To investigate and analyze the related factors of planned extubation failure in patients with severe brain injury treated with tracheal intubation. Methods: Clinical data and related factors of extubation results were collected on NICU patients who underwent tracheal intubation, experienced a >48 h intubation time, and underwent extubation. The difference between extubation success group and failure group was compared, and the risk factors of extubation were analyzed. Results: A total of 108 cases were collected with 19 cases of planned extubation failure and 89 cases of success. The difference in Glasgow coma scale （GCS）score, mechanical ventilation time, rapid shallow breathing index, and cough reflex between the two groups showed statistical significance（P<0.05）. Conclusion: GCS score, mechanical ventilation time, rapid shallow breathing index, and cough reflex are possible related determinant factors that influence the outcome of extubation