高流量吸氧对重症急性胰腺炎所致急性呼吸窘迫综合征的疗效  

Contrastive study of high-flow oxygen through nasal cannula on acute respiratory distress syndrome complicated by severe acute pancreatitis

作　　者：杜虎[1] 黄文祺[1] 王葱[2] 

机构地区：[1]重庆医科大学附属第二医院重症医学科,重庆400010 [2]重庆医科大学附属第二医院内分泌科,重庆400010

出　　处：《现代医药卫生》2017年第12期1761-1763,共3页Journal of Modern Medicine & Health

基　　金：国家自然科学基金青年科学基金资助项目(81501199)

摘　　要：目的对比分析高流量吸氧与无创呼吸机在重症急性胰腺炎(SAP)所致轻、中度急性呼吸窘迫综合征(ARDS)患者中的治疗效果。方法选取2015年8月至2017年1月该院重症医学科收治的SAP合并轻、中度ARDS常规吸氧不能改善患者80例,将其中符合纳入标准的68例患者随机分为高流量吸氧组35例和无创呼吸机组33例。比较两组患者的辅助通气治疗时间、重症监护病房(ICU)住院时间、28 d病死率、气管插管有创机械通气率、肺炎发生率等指标。结果两组28 d病死率、插管率及肺炎发生率比较,差异均无统计学意义(P>0.05)。高流量吸氧组患者辅助通气时间(127.5±53.0)h,而无创呼吸机组为(148.1±60.3)h;ICU住院时间(6.5±1.4)d,而无创呼吸机组为(8.2±2.7)d;两组辅助通气时间、住院时间比较,差异均有统计学意义(P<0.05)。结论对SAP所致轻、中度ARDS患者实施高流量吸氧的治疗措施可以明显缩短ICU治疗时间和辅助通气治疗时间,且对其28 d病死率无明显影响,值得在临床推广应用。Objective To explore the clinical effect of high-flow oxygen and noninvasive positive-pressure ventilation in patients with mild to moderate acute respiratory distress syndrome （ARDS） complicated by severe acute pancreatitis （SAP）. Methods A total of 80 cases with mild to moderate ARDS complicated by SAP were divided randomly into high-flow oxygen therapy group and noninvasive positive-pressure ventilation group in Department of Intensive Medicine of the Second Affiliated Hospital of Chongqing Medical University from August 2015 to January 2017. The clinical features such as hospital stays in inten- sive care unit （ICU）, assisted ventilation time, and the incidence rate of pneumonia and invasive mechanical ventilation were observed and compared in the two groups. Results There were no significant difference in incidence rate of 28 d mortality,invasive mechanical ventilation and pneumonia between the two groups （P〉0.058）. Compared to noninvasive positive-pressure ventilation group,assisted ventilation time [（ 127.5±53.0）h vs. （148.1±60.3）h）] and hospital stays in ICU[（6.5±1.4）d vs. （8.2±2.7）d] were significantly decreased in high-flow oxygen group （P〈0.05）. Conclusion High-flow oxygen decreased assisted ventilation time, hospital stays in ICU. It is efficient and safe, and worthy of being promoted in clinical practice.

关 键 词：胰腺炎 呼吸窘迫综合征 成人 氧吸入疗法 高流量吸氧 无创机械通气 

分 类 号：R563.8[医药卫生—呼吸系统]