经鼻高流量氧疗在急性呼吸衰竭患者拔管后的效果观察及不良反应发生率影响分析  

Effect Observation of Nasal High-flow Oxygen Therapy in Patients with Acute Respiratory Failure after Extubation and Analysis of the Incidence of Adverse Reactions

作　　者：沈阳辉[1] 曾泳萍 吴淡森[1] 石松菁[1] SHEN Yanghui;ZENG Yongping;WU Dansen;SHI Songjing(Second Department of Critical Care Medicine,Fujian Provincial Hospital,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建省立医院重症医学二科,福建福州350001

出　　处：《中外医疗》2022年第28期83-87,共5页China & Foreign Medical Treatment

摘　　要：目的评价经鼻高流量氧疗在急性呼吸衰竭患者拔管后的效果及其对不良反应发生率的影响。方法便利选取2020年5月—2021年4月来福建省立医院就诊的急性呼吸衰竭患者68例,依据电脑随机分配方式分为对照组和观察组,各34例。对照组患者接受无创机械通气治疗,观察组患者接受经鼻高流量氧疗,对比两组患者血气指标,心率、呼吸指标以及不良反应情况。结果观察组患者ICU停留时间(73.51±10.43)h、住院时间(15.44±3.24)d和机械通气时间(90.44±13.78)h优于对照组,差异有统计学意义(t=9.977、4.541、6.566,P<0.05);观察组治疗后的不良反应发生率(5.88%)显著低于对照组(26.47%),差异有统计学意义(χ^(2)=5.314,P=0.021);两组患者拔管时的PaO 2、PaCO 2、呼吸频率和心率对比,差异无统计学意义(P>0.05);拔管后6、12 h观察组患者的PaO 2、PaCO 2、呼吸频率和心率与对照组相比,差异有统计学意义(P<0.05)。结论呼吸衰竭患者拔管后采取经鼻高流量氧疗能有效缓解患者的低氧状态,改善其血气指标,促使患者尽快恢复正常呼吸。Objective To evaluate the effect of nasal high-flow oxygen therapy in patients with acute respiratory failure after extubation and its impact on the incidence of adverse reactions.Methods Conveniently selected 68 patients with acute respiratory failure who came to Fujian Provincial Hospital from May 2020 to April 2021,and divided them into control group and observation group according to the computer random distribution method,with 34 cases each.Patients in the control group received non-invasive mechanical ventilation,and patients in the observation group received nasal high-flow oxygen therapy.Blood gas indicators,heart rate,respiratory indicators and adverse reactions of patients in the two groups were compared.Results ICU stay time(73.51±10.43)h,hospital stay time(15.44±3.24)d and mechanical ventilation time(90.44±13.78)h in observation group were better than those in control group,and the difference was statistically significant(t=9.977,4.541,6.566,P<0.05).The incidence of adverse reactions in the observation group(5.88%)was significantly lower than that in the control group(26.47%),and the difference was statistically significant(χ^(2)=5.314,P=0.021).There were no statistically significant differences in PaO 2,PaCO 2,respiratory rate and heart rate between the two groups during extubation(P>0.05).There were statistically significant differences in PaO 2,PaCO 2,respiratory rate and heart rate between observation group and control group at 6 and 12 h after extubation(P<0.05).Conclusion Nasal high-flow oxygen therapy after extubation in patients with respiratory failure can effectively relieve the hypoxic state of the patients,improve their blood gas indexes,and promote the patients to resume normal breathing as soon as possible.

关 键 词：经鼻高流量氧疗 急性呼吸衰竭 拔管 不良反应 

分 类 号：R563.8[医药卫生—呼吸系统]