经鼻高流量湿化氧疗结合一氧化氮吸入对急性A型主动脉夹层术后低氧血症的临床价值研究  

Clinical Value of Nasal High Flow Humidification Oxygen Therapy Combined with Nitric Oxide Inhalation in the Treatment of Postoperative Hypoxemia after Acute Type A Aortic Dissection

作　　者：温彩云 糜小静 邱倩[1] 刘子由[1] 陈洪[1] 段志胜 WEN Caiyun;MI Xiaojing;QIU Qian;LIU Ziyou;CHEN Hong;DUAN Zhisheng(The First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China;不详)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《中国医学创新》2023年第25期20-24,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202310743)。

摘　　要：目的:探究急性A型主动脉夹层术后低氧血症患者采用经鼻高流量湿化氧疗结合一氧化氮(NO)吸入治疗的临床效果。方法:选取2020年1月—2022年9月赣南医学院第一附属医院收治的98例急性A型主动脉夹层术后低氧血症患者作为研究对象,依据治疗方案不同将其分为对照组与观察组,每组49例,对照组采用NO吸入治疗,观察组在对照组基础上同时联合经鼻高流量湿化氧疗治疗,对比两组临床指标、住院时间、机械通气率、28 d病死率、并发症发生率。结果:两组治疗前(T_(0))临床指标对比差异均无统计学意义(P>0.05);观察组治疗2 h(T_(1))、治疗12 h(T_(2))、治疗24 h(T_(3))时呼吸频率(RR)均高于对照组,治疗48 h(T_(4))时低于对照组,差异均有统计学意义(P<0.05);观察组T_(1)、T_(2)、T_(3)、T_(4)时经皮动脉血氧饱和度(SpO_(2))均高于对照组,差异均有统计学意义(P<0.05)。观察组T_(1)、T_(2)、T_(4)时氧合指数(PaO_(2)/FiO_(2))均高于对照组,T_(3)时低于对照组,差异均有统计学意义(P<0.05)。观察组T_(1)、T_(4)时二氧化碳分压(PaCO_(2))均高于对照组,T_(2)、T_(3)时均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后住院时间短于对照组,观察组治疗后机械通气率、28 d病死率、并发症发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:急性A型主动脉夹层术后低氧血症患者治疗时,经鼻高流量湿化氧疗结合NO吸入治疗,可显著减少并发症,有利于预后。Objective:To explore the clinical effect of nasal high-flow humidification oxygen therapy combined with nitric oxide inhalation in patients with hypoxemia after acute type A aortic dissection.Method:A total of 98 patients with postoperative hypoxemia of acute type A aortic dissection who were admitted to the First Affiliated Hospital of Gannan Medical University from January 2020 to September 2022 were selected as the research objects.They were divided into the control group and the observation group according to different treatment schemes,with 49 cases in each group.The control group was treated with nitric oxide(NO)inhalation,while the observation group was treated with nasal high-flow humidification oxygen therapy on the basis of the control group.The clinical indexes,hospitalization time,mechanical ventilation rate,28-day mortality rate and complication rate were compared between the two groups.Result:There was no significant differences in clinical indexes between the two groups before treatment(T_(0))(P>0.05).The respiratory rate(RR)of the observation group were higher than those of the control group at 2 h(T_(1)),12 h(T_(2))and 24 h(T_(3))after treatment,but lower than that of the control group at 48 h(T_(4))after treatment,with statistical significance(P<0.05).At T_(1),T_(2),T_(3) and T_(4),the percutaneous arterial oxygen saturation(SpO_(2))in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).At T_(1),T_(2) and T_(4),the oxygenation index(PaO_(2)/FiO_(2))in the observation group were higher than those in the control group,but lower than that in the control group at T_(3),the differences were statistically significant(P<0.05).The partial pressure of carbon dioxide(PaCO_(2))in the observation group were higher than those in the control group at T_(1) and T_(4),but lower than those in the control group at T_(2) and T_(3)(P<0.05).The hospitalization time of the observation group after treatment was shorter than that of the control group,

关 键 词：急性A型主动脉夹层 低氧血症 经鼻高流量湿化氧疗 一氧化氮吸入治疗 

分 类 号：R654.3[医药卫生—外科学]