经鼻高流量湿化氧疗在AECOPD机械通气撤机拔管后患者的应用观察

Application of nasal high-flow humidification oxygen therapy after AECOPD mechanical ventilation withdrawal

目的探讨经鼻高流量氧疗在AECOPD机械通气撤机拔管后的治疗效果。方法将我院52例ICU采用机械通气治疗的AECOPD患者分为观察组与参考组各26例,观察组在撤机后接受经鼻高流量湿化氧疗联合无创正压通气治疗,参考组仅接受无创正压通气治疗,观察2组患者治疗后生命体征、血气分析指标、ICU住院时间、呼吸机相关性肺炎(VAP)发生情况以及预后。结果治疗后观察组心率、呼吸频率、平均动脉压与参考组比较无统计学差异(P>0.05);治疗后观察组pH、PaCO_2、PaO_2与参考组比较差异显著(P<0.05);观察组住院时间明显短于参考组(P<0.05);观察组VAP发生率明显低于参考组(P<0.05);观察组病死率与参考组比较无统计学差异(P>0.05)。结论经鼻高流量湿化氧疗用于AECOPD机械通气撤机拔管后患者,能够改善机体氧含量,降低VAP发生率,缩短患者住院时间。

Objective To investigate the therapeutic effect of nasal high-flow oxygen therapy after AECOPD mechanicalventilation withdrawal. Methods 52 patients with IECO who were treated with mechanical ventilation in our hospital in thepast two years were divided into observation group and reference group according to the parallel control method. The observationgroup received nasal high-flow humidification oxygen therapy after weaning. Combined with noninvasive positive pressureventilation, the reference group received only noninvasive positive pressure ventilation. The postoperative vital signs,blood gasanalysis indicators, ICU hospitalization time, ventilator-associated pneumonia （VAP）and prognosis were observed. ResultsAfter treatment,the heart rate,respiratory rate and mean arterial pressure were not significantly different from the referencegroup （P〉0.05） . After treatment, the pH, PaCO2 and PaO2 of the observation group were significantly different from thereference group（P〈0.05） .The hospital stay was significantly shorter than the reference group（P〈0.05） .The incidence of VAPin the observation group was significantly lower than that in the reference group （P〈0.05） .There was no significant differencebetween the observation group and the reference group（P〉0.05） .Conclusion Nasal high-flow humidification oxygen therapycan improve the oxygen content of patients, reduce the occurrence of VAP and shorten the hospitalization time of patients afterAECOPD mechanical ventilation.