呼吸湿化治疗仪在低氧合患者呼吸机拔管撤机后的应用探讨

Application of respiratory humidification treatment apparatus in ventilator extubation for patients with hypoxic oxygenation

目的探讨呼吸湿化治疗仪在低氧合患者呼吸机拔管撤机后的应用效果。方法选取2013年—2017年ICU 72例氧合指数(Pa O2/Fi O2)在200～250之间撤机拔管的患者72例,分为呼吸湿化治疗仪组38例,鼻导管或面罩吸氧组34例。2组患者均采用常规治疗,比较拔管后6 h、24 h的呼吸频率、心率、氧分压、氧合指数,再插管率,并发症等指标。结果呼吸湿化治疗仪组患者拔管后6 h、24 h呼吸频率、心率低于鼻导管或面罩组,氧分压和氧合指数高于鼻导管或面罩组(P<0.05);呼吸湿化治疗仪组再次气管插管率低于鼻导管或面罩组(P<0.05),2组患者咽部不适并发症无明显统计学差异(P>0.05)。结论呼吸湿化治疗仪用于撤机拔管后患者的辅助氧疗效果明显优于传统鼻导管及面罩,值得临床推广。

Objective To explore the application effect of respiratory humidification therapy instrument in the ventilator of hypoxic patients after extubation.Methods Seventy-two ICU patients with oxygenation index(PaO2/FiO2)between 200 and 250 were selected from 2013 to 2017.There were 38 cases in respiratory therapy group,34 cases in nasal catheter or mask oxygen inhalation group.Two groups of patients were treated with routine treatment.The oxygen partial pressure,oxygenation index,re-intubation rate,complications and other indicators were compared between the two groups at 6 hours and 24 hours after extubation.Results The respiratory rate and heart rate of the patients in the respiratory therapy group were lower than those of the nasal catheter or mask group at 6 hours and 24 hours after extubation.The oxygen partial pressure and oxygenation index were higher than those of the nasal catheter or mask group,P<0.05.The rate of tracheal intubation in the respiratory therapy group was lower than that in the nasal catheter or mask group,P<0.05.There was no significant difference in complications between two groups of patients with pharyngeal discomfort,P>0.05.Conclusion After the patient is withdrawn fromthe machine,the auxiliary oxygen therapy of the respiratory humidification therapy device is obviously superior to the traditional nasal catheter and mask.It is worthy of clinical promotion.