不同主动湿化方式在气管切开脱机患者气道湿化中的应用效果

Application effects of different active humidification methods in airway humidification of patients with tracheotomy

目的:对比文丘里联合湿化器与高流量湿化氧疗2种主动湿化方式在气管切开脱机患者中的应用效果。方法:选取2020年1月至2022年8月在首都医科大学宣武医院重症医学科接受治疗的70例气管切开脱机患者为研究对象。按照随机数字表法将患者随机分为氧疗组与文丘里组,每组各35例。氧疗组脱机后实施高流量湿化氧疗,文丘里组脱机后实施文丘里联合湿化器湿化,比较2组气管切开脱机后第1、2、3天进入气管切开处气体温度、湿度、痰液黏稠度及呼吸参数[动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、外周毛细血管血氧饱和度(peripheral capillary oxygen saturation,SpO_(2))、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))],并比较干预期间并发症。结果:湿化第1、2天,2组气管切开处气体温度、相对湿度、绝对湿度比较,差异均无统计学意义(均P>0.05);湿化第3天,2组气管切开处气体温度、相对湿度、绝对湿度均接近于最佳湿化要求,且氧疗组气体温度、相对湿度均高于文丘里组(均P<0.05),2组气体绝对湿度比较,差异无统计学意义(P>0.05)。湿化第1、2、3天,2组痰液黏稠度及呼吸参数PaO_(2)、SpO_(2)、PaCO_(2)比较,差异均无统计学意义(均P>0.05)。2组并发症发生率比较,差异无统计学意义(P>0.05)。结论:文丘里联合湿化器方式能达到与高流量湿化氧疗相当的湿化效果。

Objective:To explore the application effect of 2 active humidification methods,Venturi combined humidifier and high-flow humidification oxygen inhalation,in patients with tracheotomy.Methods:A total of 70 patients with tracheotomy who were treated in the Intensive Care Unit of Xuanwu Hospital Capital Medical University from January 2020 to August 2022 were selected as the study subjects.Using the random number table method,the patients were randomly divided into a control group and an observation group,each group with 35 cases.The control group was treated with high-flow humidification oxygen therapy after weaning,and the observation group was treated with Venturi combined with humidifier humidification after weaning.The temperature,humidity,sputum viscosity,and respiratory parameters[arterial partial pressure of oxygen(PaO_(2)),peripheral capillary oxygen saturation(SpO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]of tracheotomy at the 1st,2nd,3rd day after weaning were compared between the 2 groups,and the complications during the intervention were compared.Results:On the 1st and 2nd day of humidification,there was no significant difference in gas temperature,relative humidity,and absolute humidity between the 2 groups(all P>0.05).On the 3rd day of humidification,the gas temperature,relative humidity,and absolute humidity at the tracheotomy in the 2 groups were close to the best humidification requirements,and the gas temperature and relative humidity in the oxygen therapy group were higher than those in the venturi group(both P<0.05),there was no significant difference in absolute humidity between the 2 groups(P>0.05).There was no significant difference in sputum viscosity,PaO_(2),SpO_(2),and PaCO_(2)between the 2 groups on the 1st,2nd,and 3rd day of humidification(all P>0.05).There was no significant difference in the incidence of complications between the 2 groups(P>0.05).Conclusion:Venturi combined humidifier achieves comparable humidification effect to high-flow humidified oxygen therapy.