高流量氧气湿化治疗在ICU气管插管患者拔管后的应用效果

Effects of high-flow nasal cannulae in ICU patients with tracheal intubation after extubation

目的探讨高流量氧气湿化治疗在ICU气管插管患者拔管后的应用效果,为ICU气管插管患者拔管后的有效护理提供参考依据。方法选取2016年5月~2017年10月我院重症医学科收治的80例行气管插管拔管后的患者,随机分为对照组和实验组,每组各40例。对照组采用常规氧疗,实验组采用高流量氧气湿化氧疗,比较两组气管黏膜损伤、肺部感染、再次插管发生率及通气效果。结果实验组气管黏膜损伤、肺部感染及再次插管发生率均明显低于对照组(P<0.05);拔管后24 h,实验组PaO_2、PaCO_2及BE均优于对照组,差异均有统计学意义(P<0.05)。结论高流量氧气湿化治疗对ICU气管插管拔管后患者呼吸道黏膜有保护作用,有利于预防呼吸道并发症及再次插管,改善通气效果。

Objective To explore the effect of high flow oxygen humidification treatment in ICU patients with tracheal intubation after extubation, and to provide reference for effective nursing of ICU tracheal intubation patients after extubation. Methods Totally 80 ICU patients with tracheal intubation after extubation from May 2016 to October 2017 were selected and divided randomly in the control group and the experimental group, 40 cases in each group. The control group was treated with conventional oxygen therapy, and the experimental group was treated with high flow oxygen humidification oxygen therapy. The incidence of the injury of trachea mucosa, lung infection, and reintubation were compared between the two groups, as well as the effect of ventilation. Results The incidence of tracheal mucosa injury, pulmonary infection and reintubation in the experimental group was significantly lower than that of the control group（P〈0.05）. After extubation 24 h, Pa O2, Pa CO2 and BE in the experimental group were better than those in the control group, the differences were statistically significant（P〈0.05）. Conclusion High flow oxygen humidification treatment can significantly reduce the incidence of respiratory complications and reintubation in ICU patients with tracheal intubation after extubation, and improve ventilation effect.