经鼻高流量氧疗在成人肺叶切除术后低氧血症中的临床应用  

Clinical Application of High-Flow Nasal Cannula Oxygen Therapy in Adult Patients with Hypoxemia after Pulmonary Lobectomy

作　　者：胡艳[1] 秦立珍[1] 刘彩霞[1] 黎海玲 王巍[2] Hu Yan;Qin Lizhen;Liu Caixia;Li Hailing;Wang Wei(Department of Cardiothoracic Surgery,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Department of Respiratory and Critical Care Medicine,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]胸心外科,湖北宜昌443003 [2]三峡大学第一临床医学院[宜昌市中心人民医院]呼吸与危重症医学科,湖北宜昌443003

出　　处：《巴楚医学》2020年第2期51-54,共4页Bachu Medical Journal

摘　　要：目的:探讨经鼻高流量氧疗(HFNC)在成人肺叶切除术后低氧血症中的临床应用。方法:选取我院胸心外科2018年10月~2019年6月行肺叶切除术后出现低氧血症的52例患者,随机分为试验组(n=26)与对照组(n=26),试验组应用HFNC装置进行治疗,对照组应用传统氧疗方式(即鼻导管或储氧面罩)。比较两组患者氧疗后血气相关指标、呼吸状况、氧疗时间、ICU的住院时间以及治疗失败事件。结果:试验组患者氧分压(PaO 2)、氧合指数(PaO 2/FiO 2)、心率(HR)、呼吸频率(RR)与对照组相比有明显的改善,差异均具有统计学意义(均P<0.05)。试验组患者氧疗时间及ICU住院时间也明显短于对照组,差异均具有统计学意义(均P<0.05)。试验组的二氧化碳分压(PaCO 2)和治疗失败事件与对照组相比,差异均无统计学意义(均P>0.05)。结论:HFNC可有效改善成人肺叶切除术后低氧血症的氧合及呼吸状况,但对于降低治疗失败事件无明显优势。Objective:To explore the clinical application of high-flow nasal cannula oxygen therapy(HFNC)for hypoxemia after pulmonary lobectomy.Methods:A total of 52 patients with hypoxemia after pulmonary lobectomy were randomly divided into the experimental group(n=26)and the control group(n=26).The experimental group was treated with HFNC,while the control group was treated with traditional oxygen therapy,including nasal catheter or oxygen storage mask.Blood gas related indexes,respiratory status,oxygen cure time,length of stay in ICU and incidence of treatment failure were compared between the two groups.Results:Compared with the control group,oxygen partial pressure(PaO 2),oxygen index(PaO 2/FiO 2),heart rate(HR)and respiratory rate(RR)were all significantly improved in the experimental group(all P<0.05).The oxygen cure time and length of stay in ICU were also significantly shortened by HFNC compared to the control group(both P<0.05).There were no significant differences in the partial pressure of carbon dioxide(PaCO 2)and incidence of treatment failure between the two groups(both P>0.05).Conclusion:HFNC can effectively improve the oxygenation and respiratory status in patients with hypoxemia after pulmonary lobectomy,while it has no obvious advantage in reducing treatment failure events.

关 键 词：经鼻高流量氧疗 成人肺叶切除术 低氧血症 

分 类 号：R459.6[医药卫生—治疗学]