经鼻高流量氧疗联合咳痰机对颅脑损伤患者气道管理的临床观察

Observation of Airway Management of Patients with Craniocerebral Injury by High Flow Nasal Cannula Oxygen Therapy Combined with Cough Assist

目的探究经鼻高流量氧疗(high-flow nasal cannula,HFNC)联合咳痰机对颅脑损伤气管切开患者的临床效果观察。方法选取2018年11月至2019年9月期间,在我院重症医学科收治的78例颅脑损伤行气管切开术的患者作为研究对象。采用随机数字表法分为试验组(38例)和对照组(40例)。试验组给予经鼻高流量氧疗联合咳痰机辅助治疗;对照组仅给予咳痰机辅助治疗。24 h后观察两组患者的氧合指数、痰液黏稠度、排痰量及1 w后的肺部感染率。结果两组治疗后24 h氧合指数、Ⅱ、Ⅲ度液黏稠度、排痰量及1 w后的肺部感染率比较差异均有统计学意义(P<0.05)。结论经鼻高流量氧疗联合咳痰机应用于颅脑损伤气管切开术的患者,提高了氧合指数,气道湿化与排痰效果良好,降低了肺部感染率,适合临床推广。

Objective To investigate the clinical effect of high flow nasal cannula oxygen therapy combined with cough assist in patients with craniocerebral injury who underwent tracheotomy.Methods From November 2018 to September 2019,78 patients with craniocerebral injury who underwent tracheotomy were divided into experimental group( 38 cases) and control group( 40 cases) by random digital table.The experimental group was treated with high flow nasal cannula oxygen therapy combined with cough assist.The control group was treated with cough assist only.After 24 hours,the oxygenation index,the viscosity of sputum,the amount of sputum excretion and the pulmonary infection rate after one week were observed.Results The differences between the two groups in oxygenation index,Ⅱ and Ⅲ sputum viscosity,the amount of sputum excretion and the lung infection rate one week after treatment were statistically significant( P<0.05).Conclusion The application of high flow nasal cannula oxygen therapy combined with cough assist in patients with craniocerebral injury who underwent tracheotomy has improved oxygenation index,airway humidification and sputum expelling effect,reduced lung infection rate,and is suitable for clinical application.