经鼻导管高流量湿化氧疗与无创辅助通气治疗心脏搭桥术后低氧血症患者的效果对比  

Comparison of the therapeutic effect of nasal catheter high-flow humidified oxygen therapy and noninvasive assisted ventilation in patients with hypoxemia after cardiac bypass

作　　者：黄伟[1] 程国栋[1] 朱春磊[1] 袁权富 HUANG Wei;CHENG Guo-dong;ZHU Chun-lei(Gaozhou People's Hospital,Maoming 525200,China)

机构地区：[1]高州市人民医院,广东茂名525200

出　　处：《吉林医学》2021年第7期1595-1597,共3页Jilin Medical Journal

摘　　要：目的:比较经鼻导管高流量湿化氧疗与无创辅助通气在心脏搭桥术后低氧血症患者中的治疗效果。方法:收集60例体外循环下心脏冠脉搭桥术(CABG)后患者,按拔除气管插管后给氧方式的不同分为经鼻导管高流量湿化氧疗组30例和无创辅助通气组30例。分别对比它们的呼吸频率,血氧饱和度,乳酸清除率以及需有创辅助通气干预,VAP发生率及ICU滞留时间的情况。结果:治疗后两组病例呼吸频率上的差异无统计学意义(P>0.05),无创辅助通气组血氧饱和度改善明显,乳酸清除率下降明显,差异具有统计学意义(P<0.05);高流量湿化氧疗组需更改无创或有创辅助通气干预率更高,VAP发生率更高,ICU滞留时间更长,差异有统计学意义(P<0.05)。结论:心脏术后严重低氧血症患者应及早行无创辅助通气干预,有更好血氧改善度和更低的有创通气干预率,缩短ICU滞留时间,值得临床进一步应用和探究。Objective To compare the therapeutic effect of nasal catheter high-flow humidified oxygen therapy and noninvasive assisted ventilation in patients with hypoxemia after cardiac bypass.Method Retrospectively analyze the patients after cardiac operations of 60 cases with combined with hypoxemia were divided into high-now nasal cannula oxygen therapy(HFNC)group and noninvasive mechanical ventilation(NIMV)group.There were 30 cases in HFNC group and 30 cases in NIMV group.Then to collect their oxygen saturation、respiratory rate、lactic acid clearance,the late of invasive mechanical ventilation and incidence of VAP,and the duration of ICU stays.Results The two groups had little data gap in respiratory rate,but they did not achieve statistical significance(P>0.05).The NIMV group had better improvement of the oxygen saturation and the lactic acid clearance was higher(P<0.05).The patients in HFNC group stay ICU longer,they had higher late of in invasive mechanical ventilation and incidence of VAP,and the differences were statistically significant(P<0.05).Conclusion The patients after cardiac operations with serious hypoxemia should apply noninvasive mechanical ventilation early,which would reduce the duration of ICU stays,have better improvement of the oxygen saturation and lower late of invasive mechanical ventilation.It was worth widely further applying in clinics and research.

关 键 词：低氧血症 经鼻导管高流量湿化氧疗 无创辅助通气 

分 类 号：R654.2[医药卫生—外科学]