经鼻高流量吸氧与无创机械通气治疗重症肌无力胸腺切除术后呼吸衰竭的效果比较  

Effects of high-flow nasal catheter and noninvasive mechanical ventilation on respiratory failure after thymectomy in patients with myasthenia gravis

作　　者：赵海颖[1] 何茵[1] Zhao Haiying He Yin(Department of Intensive Care Unit, Beijing TongRen Hospital, Beijing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院重症监护室,100730

出　　处：《中国实用护理杂志》2017年第26期2043-2045,共3页Chinese Journal of Practical Nursing

摘　　要：目的观察并比较2种氧疗方式对重症肌无力患者胸腺切除术后气管插管拔管后，发生急性呼吸衰竭的再插管率。方法采用病例对照的研究方法，将76例患者在气管插管拔除后应用经鼻高流量吸氧设为对照组，80例患者采用无创机械通气氧疗设为观察组，比较2组患者术后的再插管率、再插管时呼吸参数及ICU住院时间。结果观察组患者的再插管率及ICU住院时间分别为7．50％（6／80）、（3．42±1．61）d，低于对照组的18．42％（14／76）、（5．35±1．95）d，差异有统计学意义（r=4．159，P=0．041；t=5．135，P=0．025）。观察组再插管时呼吸参数中呼吸频率、SpO2、PaO2、PaCO2分别为（28．27±4．32）次／min、0．9107±0．0130、（86．43±5．66）mmHg、（57．44±5．73）mmHg，优于对照组的（24．84±2．48）次／min、0．8867±0．0309、（81．31±2．85）mmHg、（65．38±10．00）mmHg，差异有统计学意义（t=5．189～58．502，均P〈0．01或〈0．05）。结论经鼻高流量吸氧可以改善重症肌无力胸腺切除术后患者呼吸功能，降低其呼吸衰竭发生率及再插管率。Objective To observe the reintubation rate of acute respiratory failure alter thymectomy in patients with myasthenia gravis （MG） by two kinds of oxygen therapy （HFNC） and noninvasive mechanical ventilation. Methods Sixty-seven patients were treated with HFNC （observation group）, and 80 patients were treated with noninvasive mechanical ventilation（control group）. The baseline of the two groups was comparable. Results The rate of re-intubation and ICU stay time was 18.42% （14/76）, （5.35±1,95） din control group and 7.50% （6/80）, （3.42±1.61） d in observation group. The difference was statistically significant （x2=4.159, P =0.041; t =5.135, P=0.025）.The respiratory rate, SpO2, PaO2, PaCO2 was （28.27 ± 4.32）beats/rain, 0.9107 ± 0.0130, （86.43 ± 5.66）mmHg, （57.44 ± 5.73） mmHg in observation group and （24.84 ± 2.48） beats/min, 0.8867 ± 0.0309, （81.31 ± 2.85） mmHg, （65.38 ± 10.00） mmHg in control group. The difference was statistically significant （t =5.189-58.502, all P 〈 0.01 or 〈 0.05）. Conclusion HFNC can improve the respiratory function of patients with myasthenia gravis after thymectomy, reduce the incidence of respiratory failure and re-intubation rate.

关 键 词：重症肌无力 经鼻高流量吸氧 无创机械通气 再插管率 

分 类 号：R473.6[医药卫生—护理学]