经鼻高流量氧疗应用于儿童颅内肿瘤术后的评价  

Evaluation of High-Flow Nasal Cannula Oxygen Therapy Applicate to Children Intracranial Tumors Post Operation

作　　者：段宏[1] 舒蕾 吴小燕 韩琼 DUAN Hong;SHU Lei;WU Xiaoyan;HAN Qiong(Surgical Intensive Care Unit,Kunming Children’s Hospital,Kunming650032,China;Neonatal Intensive Care Unit,Yuxi Children’s Hospital,Yuxi,Yunnan653100,China;Department of Nurse,Chuxiong Medical and Pharmaceutical College,Chuxiong,Yunnan 675005,China)

机构地区：[1]昆明市儿童医院外科重症监护病房,云南昆明650032 [2]玉溪市儿童医院新生儿重症监护室,云南玉溪653100 [3]楚雄医药高等专科学校护理系,云南楚雄675005

出　　处：《昆明理工大学学报（自然科学版）》2021年第4期113-117,共5页Journal of Kunming University of Science and Technology(Natural Science)

基　　金：昆明市卫健委卫生科研课题项目(2019-04-11-001)。

摘　　要：评价儿童颅内肿瘤术后使用经鼻高流量氧疗(HFNC)作为脱机后序惯性治疗的可行性及安全性.选择2020年4月1日至2020年10月31日入住昆明市儿童医院外科ICU颅内肿瘤切除术后患者共72例.纳入标准:入住外科ICU颅内肿瘤切除术后患者且有创机械通气时间≥48 h;脱机试验成功,脱机后序贯HFNC,年龄1~14岁.对序贯HFNC治疗成功和失败组的一般资料,肿瘤位置及拔管前呼吸循环指标进行统计学分析.儿童颅脑肿瘤术后有创机械通气停止后序惯性HFNC治疗的72例患儿,其中18例失败,失败率为25%.脑干和鞍区肿瘤,以及机械通气停止前循环不稳定,GCS评分较低者均为序惯性HFNC治疗失败的独立危险因素.儿童颅内肿瘤术后序惯性HFNC治疗对于循环稳定,中枢性呼吸抑制改善,内环境稳定的患儿有一定疗效.This article evaluates the feasibility and effect of sequential treatment by High-flow Nasal Cannula Oxygen Therapy(HFNC)in mechanically ventilated children intracranial tumors post operation following endotracheal tube extubation.Seventy-two postoperative children who undergoing intracranial tumors operation were admitted to SICU of Kunming Children’s Hospital.The patients mechanically ventilated time≥48h and Spontaneous Breath Tests(SBT)were successful.The age were 1~14 years old.They were sequential treated by HFNC after mechanically ventilated.HFNC successful group and unsuccessful group general data,the position of tumour and the data of ventilation and circulation were analyzed.There were 72 cases,and 18 cases were unsuccessful.The failure rate is 25%.The brain stem tumor,sellar tumour,unstable circulation and internal environment,the lower GCS sore are the sequential treatment by HFNC independent risk factors for failure.The sequential treatment by HFNC in mechanically ventilated children intracranial tumors post operation following endotracheal tube extubation is effective when the patients circulation and internal environment are stable,central inhibition of inhalation are improved.

关 键 词：儿童 颅内肿瘤 经鼻高流量氧疗 机械通气 脱机 

分 类 号：R739.44[医药卫生—肿瘤] R730.5[医药卫生—临床医学]