经鼻高流量氧疗应用于重症肺部感染拔管后序贯干预的可行性研究  

Feasibility study of sequential intervention after extubation of severe pulmonary infection by transnasal high-flow oxygen therapy

作　　者：黄珉珉 李佳 褚一鸣 HUANG Min-min;LI Jia;CHU Yi-ming(Department of Intensive Care,People’s Hospital of Haimen District of Nantong City,Nantong Jiangsu 226100,China)

机构地区：[1]南通市海门区人民医院重症医学科,江苏南通226100

出　　处：《中国实验诊断学》2023年第7期792-796,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探究经鼻高流量氧疗(HFNC)应用于重症肺部感染拔管后序贯干预的可行性。方法选取2021年1月至2021年8月期间南通市海门区人民医院收治的82例重症肺部感染呼吸机支持的患者,根据随机数字表法将其分为观察组和对照组,每组各41例,两组机械通气拔管后,观察组采用HFNC治疗,对照组采用常规氧疗,比较两组患者治疗前,治疗24 h后呼吸功能指标[呼吸频率(R)、血氧饱和度(SPO_(2))],治疗前、治疗6 h、12 h及24 h的血气指标[氧合指数(PaO_(2)/FiO_(2))、动脉血氧分压(PaO_(2))及动脉血二氧化碳分压(PaCO_(2))],统计两组氧疗时间、呼吸机使用时间、住院时间、并发症及疾病转归情况。结果治疗24 h后R值降低,观察低于对照组,SPO_(2)水平升高,观察组高与对照组;治疗6 h、12 h及24 h的PaO_(2)/FiO_(2)值和PaO_(2)水平均升高,观察组高于对照组,PaCO_(2)水平均降低,观察组低于对照组(P<0.05);观察组氧疗时间及呼吸机使用时间较对照组缩短(P<0.05),两组患者住院时间比较,差异无统计学意义(P>0.05);观察组并发症发生率为12.20%,低于对照组的36.59%(P<0.05);观察组再插管率为4.88%,低于对照组的19.51%(P<0.05),两组患者死亡率比较差异无统计学意义(P>0.05)。结论经鼻高流量氧气湿化能够改善重症肺部感染呼吸功能及血气指标,缩短氧疗时间,有效降低患者并发症发生率和再插管率,安全可靠。Objective To explore the feasibility of sequential intervention after extubation of severe pulmonary infection by transnasal high-flow oxygen therapy(HFNC).Methods A total of 82 patients with severe pulmonary infection who received ventilator support in our hospital from January 2021 to August 2021 were selected and divided into an observation group and a control group according to the random number table method,with 41 cases in each group,After extubation by mechanical ventilation,the observation group was treated with HFNC,and the control group was treated with conventional oxygen therapy.Compare the respiratory function indexes of the two groups of patients before treatment and after 24 hours of treatment[respiratory rate(R),blood oxygen saturation(SPO_(2))].Blood gas indexes before treatment,6h,12 hand 24 hafter treatment.[Oxygenation index(PaO_(2)/FiO_(2)),arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))].The time of oxygen therapy,ventilator use time,hospital stay,complications and disease outcome of the two groups were counted.Results After 24 hours of treatment,the R value decreased,the observation was lower than the control group,the SPO_(2)level increased,and the observation group was higher than the control group.The PaO_(2)/FiO_(2)value and PaO_(2)level of treatment 6h,12h and 24h increased,the observation group was higher than the control group,the PaCO_(2)level decreased,and the observation group was lower than the control group(P<0.05).The oxygen therapy time and ventilator use time in the observation group were shorter than those in the control group(P<0.05),and there was no significant difference in hospitalization time between the two groups(P>0.05).The incidence of complications in the observation group was 12.20%,which was lower than 36.59%in the control group(P<0.05).The intubation rate in the observation group was 4.88%,which was lower than 19.51%in the control group(P<0.05).There was no significant difference in mortality between the two

关 键 词：肺部感染 重症 序贯治疗 经鼻高流量氧气湿化 

分 类 号：R563.1[医药卫生—呼吸系统]