高流量湿化氧疗在重症卒中机械通气患者序贯撤机中的应用效果  

Application effects of high-flow nasal cannula oxygen therapy in sequential weaning of mechanical ventilation in patients with severe stroke

作　　者：彭代娇 谢健 杨向意 PENG Daijiao;XIE Jian;YANG Xiangyi(Emergency Department of Ganzhou People’s Hospital,Ganzhou 341000 Jiangxi,China;Nuclear Medicine Department of Ganzhou Tumor Hospital,Ganzhou 341000 Jiangxi,China)

机构地区：[1]赣州市人民医院急诊科,江西赣州341000 [2]赣州市肿瘤医院核医学科,江西赣州341000

出　　处：《中国民康医学》2024年第19期11-13,17,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察高流量湿化氧疗(HFNC)在重症卒中机械通气患者序贯撤机中的应用效果。方法:选取2021年5月至2023年5月该院收治的118例重症卒中机械通气患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各59例。对照组机械通气撤机后行经鼻持续气道正压通气(NCPAP),观察组机械通气撤机后行HFNC。比较两组治疗前后血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]水平、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、呼吸肌力(最大吸气压、最大呼气压)水平、肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)]水平及并发症发生率。结果:治疗后,两组PaO_(2)水平均高于治疗前,且观察组高于对照组,两组PaCO_(2)水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组最大吸气压、最大呼气压等呼吸肌力水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组FVC、FEV_(1)水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为3.39%(2/59),低于对照组的15.25%(9/59),差异有统计学意义(P<0.05)。结论:HFNC应用于重症卒中机械通气患者序贯撤机,可改善血气分析指标水平,减轻神经功能损伤,提高呼吸肌力和肺功能,降低并发症发生率,效果优于NCPAP。Objective:To observe application effects of high-flow nasal cannula oxygen therapy(HFNC)in sequential weaning of mechanical ventilation in patients with severe stroke.Methods:A prospective study was conducted on 118 patients with severe stroke undergoing mechanical ventilation admitted to this hospital from May 2021 to May 2023.According to the random number table method,they were divided into control group and observation group,59 cases in each group.The control group was treated with nasal continuous positive airway pressure(NCPAP)after weaning from mechanical ventilation,while the observation group was treated with HFNC.The levels of blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],the neurological deficit score[National Institutes of Health stroke scale(NIHSS)],the respiratory muscle strength(maximum inspiratory pressure,maximum expiratory pressure),the pulmonary function[forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC)]before and after the treatment,and the incidence of complications were compared between the two groups.Results:After the treatment,the PaO_(2) levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the PaCO_(2) levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).The NIHSS scores of the two groups were lower than those before the treatment,that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The levels of respiratory muscle strength such as maximum inspiratory pressure and maximum expiratory pressure in the two groups were higher than those before the treatment,those in the observation group were higher than those in the control group,and the differences were statistically signific

关 键 词：卒中 重症 机械通气 神经功能缺损程度评分 肺功能 呼吸肌力 血气分析 

分 类 号：R541.6[医药卫生—心血管疾病]