经鼻高流量氧疗在成人心脏外科术后的应用进展  

Application Progress of High-Flow Nasal Cannula Oxygen Therapy in Adults after Cardiac Surgery

作　　者：杜欣欣 杨春波[2] 潘鹏飞[1] 于湘友[2] DU Xinxin;YANG Chunbo;PAN Pengfei;YU Xiangyou(Xinjiang Medical University,Urumqi 830011,China;Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学,乌鲁木齐830011 [2]新疆医科大学第一附属医院重症医学科,乌鲁木齐830054

出　　处：《医学综述》2018年第12期2373-2377,共5页Medical Recapitulate

基　　金：国家自然科学基金(81160232)

摘　　要：成人在心脏外科手术后常出现低氧血症、肺部感染、肺不张等并发症,在拔除气管插管后往往需要进行氧疗以维持足够的肺泡通气及氧合。经鼻高流量氧疗具有对吸入气体加温湿化、维持稳定的吸入氧浓度、清除鼻咽腔二氧化碳、产生呼气末正压效应等特点,是一种简单、有效的纠正低氧血症的方式,在临床中的应用越来越广泛。经鼻高流量氧疗用于心脏外科手术后患者的研究不多,此类患者发生急性呼吸衰竭的原因是多方面的,其疗效尚需大规模随机对照研究来证实。Adults after cardiac surgery often suffer from various complications such as hypoxemia,lung infection and atelectasis. Therefore,oxygen therapy is usually needed to maintain adequate alveolar ventilation and oxygenation after extubation. High-flow nasal oxygen cannula（ HFNC） has several features such as delivering heated and humidified oxygen,providing a stable oxygen concentration,flushing CO_2 from the nasopharyngeal cavity,creating a continuous positive airway pressure and so on. It is an easy and effective way to correct hypoxemia,and has been used in clinical practice more and more widely. While,there are only few researches about HFNC in patients after cardiac surgery. The cause of acute respiratory failure in post-cardiac surgery patients is multifactorial and large randomized controlled trials are needed to confirm the efficacy of HFNC.

关 键 词：心脏手术 经鼻高流量氧疗 生理学效应 无创正压通气 急性呼吸衰竭 

分 类 号：R459.6[医药卫生—治疗学]