摘要
目的观察肺结核合并呼吸衰竭患者有创呼吸机撤离后应用经鼻高流量鼻导管湿化氧疗或无创正压通气的临床资料,探讨经鼻高流量鼻导管湿化氧疗在肺结核合并呼吸衰竭患者有创呼吸机撤离后的临床价值。方法连续收集2019年1月1日至2024年9月30日在首都医科大学附属北京胸科医院确诊为继发性肺结核合并呼吸衰竭撤机患者65例,高流量组38例,正压组27例,收集两组患者临床资料并进行比较。结果两组一般资料比较差异无统计学意义,两组患者治疗效果比较差异无统计学意义,高流量组患者撤机后24 h的PaO_(2)及氧合指数较正压组增高,差异有统计学意义(t值分别为1.68和2.19,P<0.05和P=0.03);高流量组患者舒适度显著优于正压组,高流量组患者腹胀及皮损发生率显著低于正压组(χ^(2)=6.69和χ^(2)=3.05,P=0.01和P=0.03)。结论经鼻高流量鼻导管湿化氧疗在肺结核合并呼吸衰竭患者有创呼吸机撤离后治疗效果不劣于无创正压通气治疗,但鼻高流量鼻导管湿化氧疗更舒适,腹胀及皮损等并发症少于正压通气。
Objective To observe the clinical data of high-flow nasal cannula and non-invasive positive pressure ventilation in tuberculosis patients with respiratory failure after weaning ventilator,and to explore the clinical value of high-flow nasal cannula therapy in patients with pulmonary tuberculosis complicated by respiratory failure.Methods Sixty-five cases of patients who had been diagnosed with secondary pulmonary tuberculosis combined with respiratory failure and were weaned from the ventilator at Beijing Chest Hospital,affiliated with Capital Medical University,from 1 January 2019 to 30 September 2024 were collected.38 tuberculosis respiratory failure patients treated with high-flow nasal cannula after weaning ventilator were continuously collected as the observation group while,27 tuberculosis respiratory failure patients treated with non-invasive positive pressure ventilation after weaning ventilator during the same period were enrolled as the control group.Clinical data of the two groups were collected and compared.Results There was no significant difference in the outcomes between the two groups of patients.The PaO_(2)and P/F of patients in the high-flow nasal cannula were higher than those in the non-invasive positive pressure ventilation group at 24 hours after weaning,and the difference was statistically significant(t value was 1.68 and 2.19,P<0.05 and P=0.03,respectively).The comfort level of patients in the high-flow nasal cannula group was significantly better than that in the non-invasive positive pressure ventilation group.The incidence of abdominal distension and skin lesions in patients in the high-flow nasal cannula group was significantly lower than that in the non-invasive positive pressure ventilation group(χ^(2)=6.69 andχ^(2)=3.05,P=0.01 and P=0.03).Conclusions The therapeutic effect of nasal high-flow nasal catheter humidifying oxygen therapy in patients with pulmonary tuberculosis complicated with respiratory failure after withdrawal of invasive ventilator is not inferior to non-invasive positive pressure ventilation therapy in patients with pulmonary tuberculosis and respiratory failure after weaning of invasive ventilators.However,high flow nasal cannula therapy is more comfortable and has fewer complications compared to non-invasive positive pressure ventilation.It has fine clinical value for the patients after ventilator weaning.
作者
杨青
王睿泽
姚思雨
刘秋月
Yang Qing;Wang Ruize;Yao Siyu;Liu Qiuyue(Department of Ultrasound,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Intensive Care Medicine,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)
出处
《中国医学前沿杂志(电子版)》
北大核心
2025年第3期5-8,I0001,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
国家自然科学基金(82100011)。
关键词
肺结核
呼吸衰竭
撤机
经鼻高流量鼻导管湿化氧疗
Pulmonary tuberculosis
Respiratory failure
Ventilator weaning
High-flow nasal cannula therapy
