ICU急性呼吸衰竭患者应用高流量氧疗疗效及中医辨证探讨  

Exploration on the therapeutic effects of the high-flow oxygen therapy on acute respiratory failure patients in ICU based on TCM syndrome differentiation

作　　者：高洁[1] 王元 张淑敏[1] GAO Jie;WANG Yuan;ZHANG Shu-min(ICU Department,No. 306 Hospital of the Chinese Peopled Liberation Army,Beijing 100101)

机构地区：[1]中国人民解放军第306医院重症监护科,北京100101

出　　处：《世界中西医结合杂志》2018年第10期1448-1450,共3页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察并探讨ICU急性呼吸衰竭(ARF)患者高流量氧疗(HFT)的中医辨证疗效。方法采用自身前后对照方法,针对重症监护科(ICU) 2015年3月至2016年3月期间收治的尚未应用机械通气、普通氧疗氧合不能改善的ARF患者,收集四诊资料,观察比较在普通氧疗(应用HFT前),HFT应用30 min及1 h后的呼吸频率(R)、心率(HR)、平均动脉压(MBP)、经皮血氧饱和度(Sp O2)、血气二氧化碳分压(Pa CO2)、氧分压(Pa O2)情况,并跟踪应用HFT患者的7 d内结局(是否转为机械通气)。结果应用HFT前,HFT后30 min及1 h后的Sp O2改善明显,差异有统计学意义(P <0. 001),其中1h左右改善最明显; R在HFT应用1 h后降低(P <0. 05); HR、MBP三个时间段比较,差异无统计学意义。应用HFT 7 d内机械通气率为42. 1%,气、阳虚患者症状改善较明显。结论 HFT可以在短时间内改善ARF患者的氧合,降低呼吸频率,在一定程度上可以避免机械通气,中医辨证属"气、阳"范畴。Objective To observe and explore the therapeutic effects of high flow oxygen therapy(HFT)on acute respiratory failure(ARF)patients in ICU based traditional Chinese medicine(TCM)syndrome differentiation.Methods The self-controlled study was adopted.The ARF patients were collected from March2015to Marcy2016and they had not used yet the mechanical ventilation and had no improvement with the ordinary oxygen therapy.The data of the four diagnos-tic methods of TCM were collected.The respiratory frequency(RF),heart rate(HR)and mean arterial pressure,SpQ2,PaC02and PaQ2were observed and compared before HFT,in30min and lh of HFT.Results Compared with before HFT,in30min and lh of HFT,SpQ2was improved obviously,indicating the significant difference(P<0.001)and the im-provement was more remarkable after1h of HFT.In1h of HFT,RF was reduced(P<0.05).The differences were not sig-nificant in HR and MBP among the three time points.The mechanical ventilation rate was42.1%in7d HFT and the symptoms of qi and yang deficiency were relived obviously.Conclusions HFT improves the oxygenation in ARF patients,reduces the respiratory frequency.In the certain of extent,the application of mechanical ventilation can be avoided.The cat-egory of qi and yang are considered in TCM differentiation of ARF.

关 键 词：高流量氧疗 呼吸衰竭 中医辨证 

分 类 号：R563.8[医药卫生—呼吸系统]