经气切口高流量氧疗与文丘里面罩氧疗对老年困难撤机患者应用效果的比较

目的采用回顾性分析的方法研究高流量湿化氧疗与文丘里面罩氧疗在重症医学科气管切开的老年困难撤机患者中撤机的应用效果。方法回顾性选取2019年1月至2022年9月重症医学科气管切开状态下行机械通气的患者90例,根据撤机后序贯氧疗方式的不同,分别将其归入高流量组和文丘里组。在本院重症医学科的科室重症信息系统中回顾性搜集两组患者撤机后24 h、48 h心率(HR)、血压(BP)、动脉血气中的pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧合指数(OI)、撤机成功率以及撤机24 h、48 h的痰黏度。结果两组患者撤机后24 h的HR、PaO_(2)、OI以及24 h、48 h的BP、pH、PaCO_(2)的数据比较,差异均无统计学意义(P>0.05),但持续撤机48 h后高流量组的HR、PaO_(2)、OI、撤机成功率以及撤机24 h、48 h的痰黏度为Ⅰ~Ⅱ的患者比例均优于文丘里组,以上差异均具有统计学意义(P<0.05)。结论经气切口高流量氧疗有利于维持患者撤机后较高的氧分压,提高老年困难撤机患者的撤机成功率。

Objective To study the effect of high flow humidification oxygen therapy and Venturi mask oxygen therapy in elderly patients with tracheotomy in intensive medicine.Methods 90 patients who underwent mechanical ventilation from January 2019 to September 2022 were retrospectively selected,and were assigned to the high flow group and Venturi group according to the different methods of sequential oxygen therapy after withdrawal.The Heart rate(HR),blood pressure(BP),pH value in arterial blood gas,arterial carbon dioxide partial pressure PaCO_(2),PaO_(2),arterial oxygen index(OI),success rate and 24 h and 48 h after the withdrawal of the two groups of patients were retrospectively collected in the critical information system of the intensive care department of our hospital.Results The comparison between HR,PaO_(2),OI at 24 h after withdrawal,and BP,Ph and PaCO_(2)at 24 h and 48 h had no statistical significance(P>0.05),but the heart rate at 24 h,48 h and 48 h in the high flow group were statistically significant(P<0.05).Conclusion High-flow oxygen therapy through gas incision is beneficial to maintain the high oxygen partial pressure after machine withdrawal,and improve the success rate of elderly patients.