摘要
目的 探讨经鼻高流量吸氧对急性呼吸窘迫综合征(ARDS)患者氧合、血流动力学及脱机拔管后再插管率的影响.方法 选取90例ARDS患者,随机分为对照组与试验组,每组45例.脱机拔管后,对照组采用文丘里面罩吸氧治疗,试验组采用经鼻高流量吸氧治疗.比较两组治疗前、治疗3 d后的血气指标、氧合指标、血流动力学指标,以及辅助通气时间、ICU住院时间、脱机拔管后再插管率、治疗28 d内病死率.结果 治疗后,对照组动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)均升高(P<0.05);治疗后,试验组PaO2、动脉血氧饱和度(SaO2)、PaO2/FiO2均升高(P<0.05);治疗后,试验组PaO2、SaO2、PaO2/FiO2均高于对照组(P<0.05).治疗前后,两组组内及组间平均动脉压(MAP)、平均肺动脉压(MPAP)、中心静脉压(CVP)、肺循环阻力指数(PVRI)、心脏指数(CI)比较,差异均无统计学意义(P>0.05).试验组辅助通气时间、ICU住院时间均短于对照组,脱机拔管后再插管率、治疗28 d内病死率均低于对照组(P<0.05).结论 经鼻高流量吸氧用于ARDS患者脱机拔管后氧疗是一种有效的治疗方式,显著提高了氧合指数,患者血流动力学指标比较稳定,且降低了脱机拔管后再插管率,可作为ARDS患者脱机拔管后的一种呼吸支持的选择.
】Objective To explore the effect on oxygenation,hemodynamics and re-intubation rate after extubation by nasal high-flow oxygen infusion in patients with acute respiratory distressn syndrome(ARDS).Methods 90 patients with ARDS were randomly divided into control group and experimental group,with 45 cases in each group.After extubation,patients in control group were treated with oxygen by venturi mask,and patients in experimental group were treated with nasal high-flow oxygen infusion.The arterial blood gas,oxygenation index and hemodynamic parameters of the two groups before treatment and after 3 days of treatment were compared.The adjuvant ventilation time,ICU hospitalization time,re-intubation rate after extubation and the mortality within 28 days of treatment were compared.Results After treatment,PaO2,PaO2/FiO2 in the control group were increased(P<0.05),and PaO2,SaO2,PaO2/FiO2 were increased in the experimental group(P<0.05).PaO2,SaO2,PaO2/FiO2 in the experimental group were higher than that in the control group(P<0.05).Before and after treatment,there was no significant difference in MAP,MPAP,CVP,PVRI and CI in and between the two groups(P>0.05).Adjuvant ventilation time and ICU hospitalization time,the re-intubation rate after extubation and the mortality within 28 days of treatment in the experimental group were less than those in the control group(P<0.05).Conclusion Nasal high-flow oxygen infusion is an effective treatment for patients with ARDS after extubation,and it increases the oxygenation index,the hemodynamic parameters are relatively stable,and reduces the re-intubation rate after extubation,so it can be used as a respiratory support option for patients with ARDS after extubation.
作者
张改明
Zhang Gaiming(Department of Respiratory Medicine,Dongming County People's Hospital,Heze Shandong 274500,China)
出处
《医疗装备》
2019年第19期7-9,共3页
Medical Equipment
关键词
急性呼吸窘迫综合征
经鼻高流量吸氧
机械通气
氧疗
Acute respiratory distress syndrome
Nasal high-flow oxygen infusion
Mechanical ventilation
Oxygen therapy
