新型鼻面罩用于呼吸衰竭无创呼吸机辅助通气患者预防鼻面部压疮的临床应用

Clinical application and study of new nasal mask for prevention of nasal and facial pressure sores in patients with respiratory failure and non-invasive ventilator assisted ventilation

目的探究新型鼻面罩用于呼吸衰竭无创呼吸机辅助呼吸患者鼻面部压疮的临床疗效。方法选取本院2016年12月至2017年8月收治的130例呼吸衰竭患者,按照随机数字表法将患者分为对照组65例和观察组65例,对照组患者接传统鼻面罩,观察组患者接新型鼻面罩,观察并记录2组患者的动脉血气,鼻面部压疮、漏气率及需要插管例数,计算并比较上述情况的发生率。结果接呼吸罩进行无创正压通气(NIPPV)后24 h动脉血气中观察组动脉血氧分压(PaO_2)比对照组上升明显,动脉血二氧化碳分压(PaCO_2)比观察组下降明显;鼻面部压疮发生率对照组(18.5%)高于观察组(1.5%),对照组插管率(16.9%)高于观察组(4.6%),治疗依从性对照组(29.2%)低于观察组(61.5%),漏气率对照组(15.4%)高于观察组(4.6%),差异均具有统计学意义(P<0.05)。结论新型鼻面罩用于呼吸衰竭无创呼吸机辅助呼吸患者可更迅速地缓解患者临床表现,避免皮肤受伤从而增加治疗依从性,减少插管率,新型面罩可以减少通气过程中漏气的发生,值得临床推广应用。

Objective To explore the clinical effect of a new nasal mask on nasal and tacial pressure sores in patients with respiratory tailure and noninvasive ventilator assistedventilation non invasive positive pressure ventilation （NIPPV）. Methods One hundred and thirU patients with respiratory tailure treated in our hospital from December 2016 to August 2017 were divided into control group and observation group. The patients in control group received the traditional nasal mask and the observation group received a new nasal mask. The arterial blood gas, the pressure sore nose tace and the leakage rate in the 2 groups were observed and recorded. And the number of cases needed to be intubated, and the incidence of these cases was calculated and compared. Results PaO2 of observation group was significantly higherthan that of control group, PaCO2 of control group was significantly lower than that observation group M）er NIPPV, and the incidence of pressure sores in control group （18.5%） was significantly higher than that in observation group （1.5%）, and the rate of intubation in group control （16.9%） was significantly higher than that in observation group （4.6%）, treatment compliance in control group （29.2%） was significantly lower than that in observation group （61.5%）, and the rate of leakage rate （15.4%） was significantly higher than that of observation group （4.6%）. The ditterence was statistically significant （P〈0.05）. Conclusion The new nasal mask can be used to relieve the patients＇ clinical manitestation more quickly, avoid skin injury and increase the treatment compliance and reduce the intubation rate. The new mask can reduce the occurrence of air leakage in the process of ventilation. It is worthy of clinical application.