口鼻面罩切换装置在治疗新型冠状病毒肺炎中的临床应用  

Clinical application of oral-nasal switching device in the treatment of COVID-19

作　　者：陶夏[1] 刘晓芯[1] 蒋莉[1] 吉敏娇 Tao Xia;Liu Xiaoxin;Jiang Li;Ji Minjiao(Shanghai Chest Hospital Shanghai Jiao Tong University;Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海市胸科医院/上海交通大学附属胸科医院 [2]上海交通大学医学院附属仁济医院,上海200030

出　　处：《现代科学仪器》2021年第3期23-27,共5页Modern Scientific Instruments

基　　金：上海市教育委员会护理高原学科建设项目(编号:hlgy17092qnhb)。

摘　　要：目的为新型冠状病毒肺炎患者提供一种方便、简易的口鼻面罩切换装置。探讨口鼻面罩切换装置在临床上应用的优势。方法口鼻面罩切换装置由鼻罩和口鼻面罩两大部分组成,面罩额面部“一”字形固定,自带可拆卸薄海绵软垫,两侧接氧气管。口鼻面罩设有调节版块,方便患者吸氧、吸痰和进食。收集2020年2月至2020年3月于武汉某三甲医院ICU使用无创正压通气新冠肺炎患者40例,采用随机数字法分为观察组和对照组,各20例。其中观察组使用口鼻罩切换装置,对照组使用常规的口鼻面罩。比较两组患者治疗24小时后HR、RR、PaO2、PaCO2、SPO2等指标,比较两组的不良反应发生率、面部压疮及稳定性。结果在治疗24小时后,与对照组比较,观察组的PaO2升高较快,PaCO2、HR、RR明显下降,且观察组肺内氧合程度优于对照组,差异有统计学意义(P<0.05)。观察组无漏气现象发生,且腹部胀气、返流、不适、分泌物潴留等不良反应少于对照组,差异有统计学意义(P<0.05)。观察组面部压迫感、固定带压痕及面罩移位等发生率要低于对照组,差异有统计学意义(P<0.05)。结论为临床提供了一种简便、易行的口鼻面罩切换装置,可增加新型冠状病毒肺炎患者的依从性,降低不良反应的发生,适合临床推广。Objective To provide COVID-19 patients with a convenient and simple oral-nasal switching device and to explore the advantages of the switching device in clinical application.Methods The oral-nasal switching device was composed of two parts:nasal mask and oral-nasal mask.The mask was fixed in a"-"shape on the forehead and face,with a detachable thin sponge cushion,and connected with oxygen trachea on both sides.The oral-nasal switching device is equipped with a regulating plate,which is convenient for patients to inhale oxygen,sputum and eat.Methods Total of COVID-1940 patients who received noninvasive positive pressure ventilation in ICU from February 2020 to March 2020 in a top three hospital in Wuhan were randomly divided into observation-group and control-group,20 cases in each group.The observation group used the oral-nasal switching device,the control group used the conventional oral-nasal mask.HR,RR,PaO2,PaCO2and SPO2 indexes were compared between the two groups 24 hours after treatment,and the incidence of adverse reactions,facial pressure sore and stability were compared between the two groups.Results Compared with the control group,PaO2 in the observation group increased rapidly,PaCO2,HR,RR decreased significantly,and the degree of pulmonary oxygenation in the observation-group was better than that in the control-group after 24 hours of treatment,the difference was statistically significant(P<0.05).There was no leakage phenomenon in the observation-group,and the adverse reactions such as abdominal distension,reflux,discomfort and secretion retention were less than those in the control-group,the difference was statistically significant(P<0.05).The incidence of facial pressure,fixed band indentation and mask displacement in the observation-group was lower than that in the control-group,and the difference was statistically significant(P<0.05).Conclusion The oral-nasal switching device is provided for clinical application,which can increase the compliance of COVID-19 patients and reduce the occurrence of adv

关 键 词：口鼻面罩 新型冠状病毒肺炎 正压通气 

分 类 号：R47[医药卫生—护理学]