Stanford A型主动脉夹层术后拔除气管插管预防性给予高流量氧疗的效果

Effect of prophylactic high flow oxygen therapy in extubation of endotracheal tube after operation of Stanford type A aortic dissection

目的:探究高流量氧疗在Stanford A型主动脉夹层后拔除气管插管中的应用效果。方法:选取2018年5月-2019年1月Stanford A型主动脉夹层术后拔出气管插管患者94例,按氧疗方法分为两组,各47例。对比组给予面罩式雾化器吸氧治疗;试验组给予呼吸机高流量氧疗。比较两组临床疗效。结果:试验组撤机2 d后口腔鼻腔干燥评分及咽喉疼痛评分均低于对比组,差异有统计学意义(P<0.05);试验组低氧血症发生率及二次插管率均低于对比组,差异有统计学意义(P<0.05)。两组撤机2 d后PaO2水平均低于撤机前,且试验组降低幅度小于对比组,差异有统计学意义(P<0.05);试验组撤机2 d后PaCO2水平优于对比组,差异有统计学意义(P<0.05)。结论:高流量氧疗在Stanford A型主动脉夹层后拔除气管插管中的应用效果显著。

Objective:To explore the effect of high flow oxygen therapy in extubation of endotracheal tube after operation of Stanford type A aortic dissection.Methods:From May 2018 to January 2019,94 patients with extubation of endotracheal tube after operation of Stanford type A aortic dissection were selected.According to the oxygen therapy method,they were divided into two groups of 47 cases in each.The control group was treated with oxygen absorption by mask atomizer.The experimental group was treated with high flow oxygen therapy of ventilator.We compared the clinical efficacy of the two groups.Results:In the experimental group,after 2 days of machine withdrawal,the scores of dry mouth and nose and throat pain were lower than those in the control group,the difference was statistically significant(P<0.05).In the experimental group,the incidence of hypoxemia and the rate of second intubation were lower than those in the control group,the difference was statistically significant(P<0.05).The PaO2 level of the two groups after 2 days of machine withdrawal was lower than that of before machine withdrawal,and the reduction of the experimental group was smaller than that of the control group,the difference was statistically significant(P<0.05).In the experimental group,after 2 days of machine withdrawal,the PaCO2 level was better than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The effect of high flow oxygen therapy in extubation of endotracheal tube after operation of Stanford type A aortic dissection is significant.