经鼻高流量湿化氧疗对气管插管拔管后患者的临床疗效  

Clinical efficacy of high-flow nasal cannula in patients after tracheal extubation

作　　者：朱莉 侬宇琴 ZHU Li;NONG Yuqin(Department of Emergency,North Section of Huashan Hospital Affiliated to Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学附属华山医院北院急诊科,上海200433

出　　处：《西北国防医学杂志》2019年第3期182-185,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨经鼻高流量湿化氧疗(high-flow nasal cannula,HFNC)对气管插管拔管后患者的临床疗效。方法:选择2017-01～2018-01收治的气管插管拔管后的100例危急重症治疗患者为研究对象,随机分为对照组和研究组,每组各50人。对照组拔管后给予文丘里面罩吸氧,研究组给予HFNC,比较两组拔管后血气分析结果、生命体征情况、耐受性评分、舒适度评分和护理操作难易程度。结果:研究组气管插管拔除后8 h、24 h的动脉血氧分压(arterial partial pressure of oxygen,PaO_2)较对照组升高,而动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_2)、心率(heart rate,HR)、呼吸频率(respiratory rate,RR)和血压(blood pressure,BP)较对照组降低,差异均有统计学意义(P<0.05)。研究组耐受性评分、舒适度评分和护理操作难易程度评分均明显低于对照组,差异均有统计学意义(P<0.05)。结论:气管插管拔管后患者采用HFNC疗效明显,可有效改善低氧血症患者的氧合指数,降低HR和RR,提高患者舒适度和耐受性,值得临床推广应用。Objective:To explore the clinical efficacy of high-flow nasal cannula(HFNC)in patients after tracheal extubation.Methods:A total of 100 cases after tracheal extubation from January 2017 to January 2018 were divided into the experimental group and the control group,50 cases in each group.The control group were treated with noninvasive mechanical ventilation,while the experimental group were treated with HFNC.After the treatment,the blood gas analysis results,vital signs,tolerance scores,patient comfort score and nursing service difficulty were compared between the two groups.Results:The arterial partial pressure of oxygen(PaO2)in experimental group was higher than that in control group,while the arterial partial pressure of blood carbon dioxide(PaCO2),heart rate(HR),respiratory rate(RR)and blood pressure(BP)were lower than those in control group at 8 hand 24 hafter tracheal extubation,the differences were statistically significant(P<0.05).The tolerance scores,patient comfort score,nursing service difficulty in the experimental group were lower than those in control group(P<0.05).Conclusion:The HFNC have obvious curative effect on patients after tracheal intubation,which can effectively improve the oxygenation index,reduce HR and RR of patients with hypoxemia,improve patient comfort and tolerance,and it is worthy of clinical application.

关 键 词：经鼻高流量湿化氧疗 气管插管拔管 临床疗效 护理 

分 类 号：R563.8[医药卫生—呼吸系统]