HHFNC在呼吸衰竭机械通气拔管后应用的效果观察

Observation of the effect of HHFNC after extubation of mechanical ventilation in respiratory failure

目的探讨急性呼吸衰竭机械通气治疗患者拔管后采用经鼻高流量湿化氧疗(HHFNC)治疗的效果。方法选取我院急诊科采用机械通气救治的90例急性呼吸衰竭患者作为研究对象,采用随机数字表分为研究组和对照组各45例,研究组采用HHFNC治疗、对照组采用文丘里面罩吸氧。结果拔管后12h,研究组的氧合指数、PaO 2测定值、血乳酸变化率、ScvO2变化率高于对照组(P<0.05),研究组的PaCO 2低于对照组(P<0.05);研究组的再插管率低于对照组(P<0.05),研究组和对照组的病死率及呼吸机相关肺炎发生率差异无统计学意义(P>0.05)。结论急性呼吸衰竭机械通气治疗患者拔管后采用HHFNC治疗更有利于维持患者血气水平,减轻拔管后血乳酸升高及ScvO2变化率,可提高拔管插管率。

Objective To explore the effect of nasal HHFNC treatment after extubation in patients with acute respiratory failure mechanical ventilation.Methods 90 patients with acute respiratory failure treated by mechanical ventilation in the emergency department of our hospital were selected as the research object,and they were randomly divided into the study group and the control group with 45 cases each.The study group was treated with HHFNC,and the control group was ventilated with oxygen inside the venturi.Results 12 hours after extubation,the oxygenation index,PaO 2 measured value,blood lactate change rate,and ScvO2 change rate of the study group were higher than those of the control group(P<0.05).PaCO2 in the study group was lower than that in the control group(P<0.05).The re-intubation rate in the study group was lower than that in the control group(P<0.05).There was no statistically significant difference in the mortality and the incidence of ventilator-associated pneumonia between the two groups(P>0.05).Conclusion HHFNC is more conducive to maintaining the patient′s blood gas level and reducing the increase in blood lactate and ScvO2 change rate after extubation in treatment of patients with acute respiratory failure after mechanical extubation,which can increase the extubation rate.