高流量鼻导管氧疗与无创通气在拔管后呼吸衰竭中的应用比较  

Comparison of high-flow nasal cannula oxygen therapy and non-invasive ventilation on respiratory failure after endotracheal extubation

作　　者：沈光贵[1] 仲昌顺 袁荆 陈群[1] 秦雪梅[1] 鲁卫华[1] 王箴[1] SHEN Guanggui;ZHONG Changshun;YUAN Jing;CHEN Qun;QIN Xuemei;LU Weihua;WANG Zhen(Department of Critical Care Medicine,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241000,China)

机构地区：[1]皖南医学院弋矶山医院重症医学科,安徽芜湖241000

出　　处：《安徽医药》2021年第2期292-295,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省中央引导地方科技发展专项项目(201907d07050001);重大疾病非编码RNA转化研究安徽普通高校重点实验室开放课题(RNA201910)。

摘　　要：目的比较高流量鼻导管氧疗与无创通气在拔管后呼吸衰竭中应用的有效性。方法回顾性分析皖南医学院弋矶山医院重症医学科2017年11月至2019年10月气管拔管后呼吸衰竭病人77例。按治疗方法分为无创通气治疗组(41例)及高流量鼻导管氧疗治疗组(36例)。对比两组在避免气管再插管率、拔管后滞留重症监护室(ICU)时间及病死率等临床指标。结果高流量鼻导管氧疗组和无创通气组在避免气管再插管率方面差异无统计学意义(77.78%比65.85%,χ^2=1.336,P=0.248)。两组的拔管后ICU滞留时间[(9.23±6.360)d比(10.20±8.73)d,t=0.550,P=0.584]、ICU病死率(13.89%比14.63%,χ^2=0.009,P=0.926)及院内病死率(16.67%比17.07%,χ^2=0.002,P=0.962)均差异无统计学意义。结论高流量鼻导管氧疗可替代无创机械通气治疗气管插管拔管后呼吸衰竭病人。Objective To compare the effectiveness of high-flow nasal cannula(HFNC)and noninvasive ventilation(NIV)on the patients with respiratory failure after endotracheal extubation.MethodsA retrospective study was conducted on 77 patients with respiratory failure after endotracheal extubation in the Department of Critical Care Medicine,Yijishan Hospital,Wannan Medical College from November 2017 to October 2019.41 patients were treated with noninvasive ventilation,and 36 patients were treated with high-flow nasal catheter.A series of parameters,including the rate of avoiding endotracheal intubation,the length of ICU stay after extubation and mortality,were compared between two groups.ResultsThere are no significant differences between two groups in the following parameters:the rate of avoiding endotracheal intubation(77.78%vs.65.85%,χ^2=1.336,P=0.248),the length of ICU stay after extubation(9.23±6.36 days vs.10.20±8.73 days,t=0.550,P=0.584),the mortality in ICU(13.89%vs.14.63%,χ^2=0.009,P=0.926)and the hospital mortality(16.67%vs.17.07%,χ^2=0.002,P=0.962).Conclusion HFNC oxygen therapy can replace NIV in the patients with respiratory failure after endotracheal extubation.

关 键 词：呼吸衰竭 气管插管拔除 无创通气 高流量鼻导管氧疗 

分 类 号：R563.8[医药卫生—呼吸系统]