摘要
目的:探讨高流量鼻导管吸氧(HFT)在急性呼吸衰竭(ARF)气管插管机械通气患者拔管序贯通气中的应用效果。方法:将重症监护室(ICU)行有创机械通气>48 h的84例ARF患者正常程序拔管脱机后,随机分为观察组与对照组,每组各42例,对照组患者拔管后予以低流量鼻导管吸氧(LFT),观察组患者拔管后予以HFT,比较两组患者序贯治疗时间、再插管率、通气48 h及转出ICU时血气分析指标、急性生理与慢性健康评分(APACHEⅡ)。结果:观察组患者序贯通气时间、总通气时间及住ICU时间短于对照组(P<0.05),再插管率低于对照组(P<0.05);且序贯通气24 h时、转出ICU时观察组患者血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)高于对照组(P<0.05),APACHEⅡ评分、二氧化碳分压(PaCO_2)、呼吸频率(RR)低于对照组(P<0.05);观察组患者耐受度及舒适度评分均低于对照组(P<0.05)。结论:ARF拔管序贯通气患者应用HFT能提高患者耐受性及舒适度,改善血气分析参数,缩短通气时间,降低再插管率。
Objective:To explore the effect of high-flow nasal catheter oxygen therapy(HFT)in sequential ventilation after extubation of patients with acute respiratory failure(ARF).Methods:84 patients with ARF treated with invasive mechanical ventilation for more than 48 h in Intensive Care Unit(ICU)after extubation and weaning in standard procedure were randomly divided into observation group(n=42)and control group(n=42).The control group was given low-flow nasal catheter oxygen therapy(LFT),and the observation group was given HFT.The sequential ventilation time,reintubation rate,blood gas analysis indexes and APACHEⅡscore at ventilated 48 h and out of the ICU were compared.Results:The sequential ventilation time,total ventilation time and ICU stay in the observation group were significantly shorter than those in the control group(P<0.05),and the reintubation rate was lower than that in the control group(P<0.05).At ventilated 48h and out of the ICU,the PaO 2,PaO 2/FiO 2 in the observation group were significantly higher than those in the control group while the APACHEⅡscore,PaCO 2 and respiratory rate(RR)were significantly lower than those in the control group(P<0.05).The tolerance and comfort scores in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:HFT can significantly improve the patient's tolerance and comfort and the blood gas analysis parameters,and shorten the ventilation time and reduce the reintubation rate in sequential ventilation after extubation of ARF.
作者
叶文华
梁福攸
罗健成
YE Wenhua;LIANG Fuyou;LUO Jiancheng(The People's Hospital in Nanhai District,Foshan 528200,China)
出处
《包头医学院学报》
CAS
2018年第4期30-32,共3页
Journal of Baotou Medical College
关键词
急性呼吸衰竭
高流量鼻导管吸氧
序贯
机械通气
Acute respiratory failure
High-flow nasal catheter oxygen therapy
Sequential
Mechanical ventilation
