摘要
目的探讨应用经鼻高流量湿化氧疗(HHFNC)对肺移植受者肺康复效果的影响。方法回顾性分析2015年1月至2016年1月南京医科大学附属无锡市人民医院22例肺移植术受者,根据术后通气方案不同,将受者分为HHFNC组和持续气道正压通气(CPAP)组。观察并比较两组受者基本资料、呼吸功能、血气分析结果及生活质量指标。采用两样本独立t检验比较两组受者年龄、APACHEⅡ等正态分布计量资料;采用配对t检验比较两组受者术后3个月和入院时SGRQ得分。采用Wilcoxon检验比较待肺时间、机械通气时间等非正态分布计量资料。P<0.05为差异有统计学意义。结果 HHFNC组和CPAP组受者年龄、APACHEⅡ评分、身高、体质量、体质量指数、性别及待肺时间差异均无统计学意义(P均>0.05)。两组受者机械通气时间、拔除人工气道时呼出潮气量及ICU住院时间差异均无统计学意义(P均>0.05)。两组受者进入ICU时、拔除经口气管插管时及转出ICU前血清p H值、脉搏血氧饱和度、动脉血二氧化碳分压、氧合指数、血清乳酸差异均无统计学意义(P均>0.05)。HHFNC组受者转出ICU前呼出潮气量及氧合指数均高于CPAP组(t=6.43、3.42,P均<0.05),而血清乳酸含量低于CPAP组(U=2.56,P<0.05)。HHFNC组受者入院时生活质量低于术后3个月,差异有统计学意义(t=5.10,P<0.05);CPAP组入院时生活质量与术后3个月差异无统计学意义(t=0.81,P>0.05)。结论 HHFNC可有效改善肺移植受者移植肺功能和早期生活质量。
Objective To evaluate the effect of humidified high flow nasal cannula （HHFNC） on rehabilitation of patients after lung transplantation. Methods Retrospective analysis 22 patients who got pulmonary transplantation in Wuxi people＇s Hospital Affiliated to Nanjing Medical University between January 2015 and January 2016. According to the different ventilation scheme, patients were divided into HHFNC group and continuous positive airway pressure （CPAP） group after artificial airways were removed. The general situation, respiratory function, blood gas analysis and quality of life of the two groups were observed and recorded. The general situation, respiratory function, quality of life, age and APACHE II score between the two groups was compared by independent sample t-test. SGRQ score between admission and three months among the two groups was compared by pair t test, respectvely. Abnormal distribution measurement data such as latency for lung transplantation and mechanical ventilation time between the two groups was compared by Wilcoxon test. P 〈 0.05, the difference was statistically significant. Results The index of age, APACHE 1I score, body height, body weight, body mass index, gender and latency for lung transplantation between HHFNC group and CPAP group showed no statistical differences （P all 〉0.05 ）. There was no significant difference between the two groups in mechanical ventilation time, exhaled tidal volume and the length of time the ICU （ P all 〉 0.05 ）. There was no significant difference between the two groups on oxygenation index and serum lactic acid value when entering ICU and tracheal extubation was done （ P all 〉0. 05 ）. TheHHFNC group had higher exhaled tidal volume and oxygenation index than the CPAP group before out of ICU （t = 6.43, 3.42, P all 〈 0. 05）. The HHFNC group had lower lactic acid than the CPAP group （ U = 2.56, P 〈 0. 05）. Statistic difference was found on life quality between admission to hospotial and 3 months after transplantation in HHFNC group （ t = 5. 10, P 〈 0.05 ）, while there was no statistic difference in CPAP group （ t = 0. 81, P 〉 0.05 ）. Conclusion HHFNC could effectively improve pulmonary function and early life quality.
作者
潘红
黄琴红
许红阳
王大鹏
杨学芳
龚靓
张毓
柳微
陈静瑜
Pan Hong Huang Qinhong Xu Hongyang Wang Dapeng Yang Xuefang Gong Liang Zhang Yu Liu Wei Chen Jingyu(Cardiopulmonary ICU Department of Lung Transplantation, Wuxi people＇s Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China)
出处
《中华移植杂志（电子版）》
CAS
2016年第4期182-185,189,共5页
Chinese Journal of Transplantation(Electronic Edition)
基金
无锡市医院管理中心医学技术面上项目(YGZXM1527)
关键词
经鼻高流量湿化氧疗
康复
肺移植
肺功能
Humidified high flow nasal cannula
Rehabilitation
Lung transplantation
Pulmonary function
