高流量鼻导管氧疗治疗食道癌术后呼吸衰竭一例

High-flow nasal cannula oxygen therapy for respiratory failure in a post-esophagectomy patient: A case report

急性呼吸衰竭是食道癌术后常见的并发症,食道癌术后患者由于术中肺萎陷、重力依赖区肺泡塌陷、肺微血管内皮细胞损伤、胸腔胃、痰液黏稠及术后疼痛等原因会导致通气及换气功能障碍。无创机械通气往往是这一类患者的相对禁忌。随着经鼻高流量氧疗技术的不断进步,其无创、减少口鼻咽部解剖死腔、呼气末正压通气(PEEP)效应、增加呼气末肺容积、气道湿化和改善舒适度等优点被广泛认识,其能够改善食道癌术后患者的氧合,避免再次插管。本文就经鼻高流量对1例食道癌术后患者呼吸衰竭的治疗进行介绍。

Acute respiratory failure is a common complication after radical resection of esophageal carcinoma.Dependent area alveolar collapse in and after surgery,pulmonary microvascular endothelial injury,intrathoracic stomach,sticky sputum and postoperation pain could lead to ventilational dysfunction.Noninvasive ventilation is relatively contraindicted for patients with these medical situations.High-flow nasal cannula oxygen therapy has a number of medical benefits:reduction of anatomical dead space,PEEP effects,increase in end-expiratory lung volume,improved comfort.High-flow nasal cannula oxygen can improve oxygenation of post-esophagectomy patients and avoid reintubation.This paper introduces the effects of highflow nasal cannula oxygen therapy on respiratory failure in a post-esophagectomy patient.