序贯经鼻高流量氧疗用于慢性阻塞性肺疾病拔管后的临床效果  

Clinical effect of sequential transnasal hyperflow oxygen therapy for COPD after extubation

作　　者：林锦锋[1] 梁锦堂[1] 姚慧文[1] 钟景良[1] LIN Jin-feng;LIANG Jin-tang;YAO Hui-wen(Department of Critical Care Medicine,Jiangmen Xinhui District People's Hospital,Jiangmen 529000,China)

机构地区：[1]江门市新会区人民医院重症医学科,广东江门529000

出　　处：《吉林医学》2021年第6期1343-1346,共4页Jilin Medical Journal

摘　　要：目的:探究慢性阻塞性肺疾病(COPD)患者拔管后序贯经鼻高流量氧疗的临床应用效果。方法:本次试验对象均选自本院2018年2月~2020年1月期间收治的94例COPD患者,按照不同的氧疗方式对患者进行分组,其中47例开展序贯经鼻高流量氧疗的为试验组,另外47例开展无创机械通气的为对照组,分析两种氧疗方式的治疗效果。结果:两组患者的呼吸指数、氧合指数、PaCO_(2)、FEV_(1)/FVC、FEV_(1)%预测值以及FEV_(1)相比,治疗前试验组和对照组相比,差异无统计学意义(P>0.05),治疗后除PaCO_(2),其他指标均有统计学意义(P<0.05);对比试验组和对照组的治疗舒适度、痰液黏稠度、耐受度、咳痰难度评分,试验组更佳,差异有统计学意义(P<0.05);试验组和对照组的ICU居住时间、气管切开率、再次插管率对比,试验组更优,差异有统计学意义(P<0.05);在死亡率、不良事件发生率上,试验组分别为4.26%和6.38%,对照组为10.64%和23.40%,不良事件发生率对比,差异有统计学意义(P<0.05),死亡率对比,差异无统计学意义(P>0.05)。结论:COPD患者拔管后序贯经鼻高流量氧疗的应用能够促进患者恢复,可有效调节其肺功能和通气,且不会产生不适感。Objective To explore the clinical effect of sequential nasal high-flow oxygen therapy after extubation in patients with chronic obstructive pulmonary disease(COPD).Method The subjects were selected from our hospital in February 2018 to January 2020,admitted during the period of 94 cases of COPD patients,according to the different way of oxygen cure for grouping patients,47 cases of sequential nasal high flow oxygen therapy as the experimental group,and 47 cases of noninvasive mechanical ventilation to control group,analyze the therapeutic effect of two types of oxygen therapy.Results There was no significant difference in respiratory index,oxygenation index,PaCO_(2),FEV1/FVC,FEV_(1)%predictive value and FEV1 between the experimental group and the control group before treatment(P>0.05).After treatment,other indicators were statistically significant except PaCO_(2)(P<0.05).The treatment comfort,sputum viscosity,tolerance and sputum difficulty score of the experimental group and the control group were compared,and the experimental group was better(P<0.05).Compared with the control group,the duration of ICU stay,tracheotomy rate and re-intubation rate of the experimental group were better(P<0.05).In terms of mortality and adverse event incidence,4.26%and 6.38%in the experimental group and 10.64%and 23.40%in the control group,respectively.There was significant difference in adverse event incidence(P<0.05),and no difference in mortality(P>0.05).Conclusion The application of sequential nasal hyperflow oxygen therapy after extubation in COPD patients can promote patient recovery,effectively regulate their lung function and ventilation,and do not produce discomfort.

关 键 词：经鼻高流量氧疗 慢性阻塞性肺疾病 拔管 无创机械通气 肺功能 血气指数 

分 类 号：R563.9[医药卫生—呼吸系统]