经鼻高流量氧疗与文丘里面罩氧疗在ICU成人机械通气患者拔管后的应用研究  

Study on the application of high flow nasal oxygen therapy and venturi mask oxygen therapy after extubation in adult patients received ICU mechanical ventilation

作　　者：李亚军[1] 陈莲芳[1] 陶娜 韩汝宁 牛振业 李秀川[4] LI Ya-jun(Department of intensive care units,first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China.)

机构地区：[1]蚌埠医学院第一附属医院重症医学科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院急诊外科,安徽蚌埠233000 [3]蚌埠医学院护理学院 [4]蚌埠医学院第一附属医院护理部,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2019年第20期2529-2532,共4页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学基金重点项目(BYKY1857ZD)

摘　　要：目的 比较经鼻高流量氧疗与文丘里面罩氧疗在ICU成人机械通气患者拔管后应用效果,为临床成人机械通气患者拔管后氧疗工具的选择提供一定的依据。方法 选择2018年10月-2019年6月在本院综合ICU和急诊ICU行机械通气的64例患者作为研究对象,随机分为实验组(33例)和对照组(31例)。两组患者均按照统一标准行脱机拔管,拔管后实验组采用经鼻高流量氧疗,对照组采用文丘里面罩氧疗。观察两组患者一般临床资料,比较拔管前及拔管后2 h、24 h和48 h氧合指数(PO2/Fi O2),动脉二氧化碳分压(PCO2),呼吸频率的变化;比较拔管后2 h、24 h和48 h氧疗的不舒适度。结果 在拔管后24 h、48 h,实验组在氧合指数上明显优于对照组,差异有统计学意义(P<0.05);拔管后24 h、48 h实验组在动脉二氧化碳分压(PaCO2),呼吸频率也低于对照组,差异有统计学意义;拔管后24 h、48 h在舒适度方面,实验组也明显优于对照组。结论 在成人机械通气患者拔管后氧疗工具选择上,相比文丘里面罩,经鼻高流量可降低患者拔管后的呼吸频率,提高氧合指数,降低氧疗工具带来的不舒适,值得临床广泛推广。Objective To compare the application effect of high flow nasal oxygen therapy and venturi mask oxygen therapy in ICU adult mechanical ventilation patients after extubation,and to provide a certain basis for the selection of oxygen therapy tools after extubation for clinical adult patients received mechanical ventilation.Methods Sixty-four patients with mechanical ventilation those who came from integrated ICU and emergency ICU from October 2018 to June 2019 in our hospital were randomly divided into the experimental group(33 cases)and the control group(31 cases).Two groups of patients were treated in accordance with the unified offline drawing tube,high flow nasal oxygen therapy and venturi mask oxygen therapy were used in experimental group and control group,respectively,after tube drawing.Changes in oxygenation index(PO2/Fi O2),arterial partial carbon dioxide(PCO2)and respiratory frequency were compared before and after extubation(2 h,24 h and48 h).The discomfort of oxygen therapy at 2 h,24 h and 48 h after extubation were compared.Results 24 h and48 h after extubation,the oxygenation index of the experimental group was significantly better than that of the control group,and the difference was statistically significant.At 24 h and 48 h after extubation,the arterial partial carbon dioxide(PaCO2)and breathing rate of the experimental group was lower than that of the control group,with statistically significant difference.24 h and 48 h after extubation,the comfort level of the experimental group was also significantly better than that of the control group.Conclusions Compared with venturi mask,high flow nasal could reduce the respiratory frequency of patients after extubation,improve the oxygenation index and reduce the discomfort brought by oxygen therapy tools in adult patients received mechanical ventilation,which is worthy of wide clinical promotion.

关 键 词：机械通气 经鼻高流量 文丘里面罩 氧疗 

分 类 号：R459.7[医药卫生—急诊医学]