急诊监护室临床氧疗管理现状的调查分析

Investigation on management of clinical oxygen therapy in EICU

目的调查急诊监护室临床氧疗管理现状,分析氧疗实践中存在的问题,为临床规范重症患者氧疗实践提供依据。方法采用回顾性分析法,选取2022年1月-10月笔者所在医院急诊监护室收治的353例重症氧疗患者的临床资料,调查不同氧疗方式下高氧血症的发生情况,以及患者发生高氧血症4 h内和10 h内氧浓度下调情况。结果353例氧疗患者,共涉及动脉血气标本3483份,PaO_(2)≥120 mmHg的标本有1239份,248例患者氧疗期间发生高氧血症,占比70.25%。不同氧疗方式组间高氧血症发生率、氧分压和氧合指数比较,差异均有统计学意义(均P<0.001)。患者发生高氧血症后4 h内和10 h内氧浓度下调比例分别为14.12%和26.23%,不同氧分压组氧浓度下调比例比较,差异均有统计学意义(均P<0.001)。结论急诊监护室氧疗管理有待改进,重症氧疗患者高氧血症发生率较高,医护人员应重视过度氧疗危害,纠正氧疗认知误区,规范实施目标氧疗,以保障临床氧疗的安全。

Objective To investigate the current situation of clinical oxygen therapy management in the emergency intensive care unit(EICU),so as to find problems and provide references for the standardization of oxygen therapy practice.Methods Totally 353 EICU patients between January and October 2022 were selected and their clinical date were analyzed.The incidence of hyperoxemia of different oxygen therapies,and the reduction of oxygen concentration within 4 and 10 hours after the occurrence of hyperoxemia.Results For 3483 samples of the 353 patients,248 patients(70.25%)were of hyperoxemia with 1239 samples of PaO_(2)≥120 mmHg.Significant differences were observed in the incidence of hyperoxemia,oxygen partial pressure and oxygenation index among patients with difference oxygen therapy plans(P<0.001).With 4 and 10 hours after the occurrence of hyperoxemia,the oxygen concentration decreased among 14.12%and 26.23%respectively.Moreover,there were significant differences in the reduction ratio of oxygen concentration in different oxygen pressure ranges(P<0.001).Conclusion Oxygen therapy management in EICU needs improving as the incidence of hyperoxemia is high among EICU patients.Therefore,much attention should be paid to the harm of excessive oxygen therapy,correct the misunderstanding of the oxygen therapy,so as to implement targeted oxygen therapy and ensure the safety of such therapy.