呼吸衰竭患者气管插管拔除后序贯经鼻高流量氧疗与普通面罩氧疗的效果比较

Comparing sequential high-flow nasal cannula oxygen therapy and conventional mask oxygen therapy in patients with respiratory failure after tracheal extubation

目的:比较经鼻高流量氧疗(HFNC)与普通面罩氧疗在呼吸衰竭患者气管拔管后的序贯应用效果。方法:选取2022年3~9月弋矶山医院EICU收治的呼吸衰竭气管插管患者40例,利用计算机产生随机序列号将患者分为高流量氧疗组(HFNC组)和普通面罩组(对照组)各20例,比较两组患者序贯氧疗24 h后的氧合指数(PaO_(2)/FiO_(2))、二氧化碳分压(PaCO_(2))、呼吸与心率以及48 h再插管率、EICU住院时间和病死率的差异。结果:序贯氧疗24 h后,HFNC组PaO_(2)/FiO_(2)、PaCO_(2)较普通面罩组高,呼吸频率及心率较普通面罩组低(P<0.001);HFNC组再插管率低于普通面罩组(P<0.05);两组EICU住院时间及病死率差异无统计学意义(P>0.05)。结论:HFNC与普通面罩相比,能够显著提升呼吸衰竭患者气管拔管后的PaO_(2)/FiO_(2),降低患者的呼吸频率和心率,且可降低48 h再插管率。

Objective:To compare the sequential effects of high-flow nasal cannula(HFNC)oxygen therapy and common mask oxygen therapy in patients with respiratory failure after tracheal extubation.Methods:Forty patients with respiratory failure admitted to EICU in our hospital were included from March to September of 2022,and divided into HFNC group(n=20)and common mask group(control group,n=20)as the serial number randomly generated by computer.The two groups were compared pertinent to difference in oxygenation index(PaO_(2)/FiO_(2)),partial pressure of carbon dioxide(PaCO_(2)),respiration rate,heart rate,re-intubation rate within 48h,length of EICU stay and mortality rate 24 hours after sequential oxygen therapy.Results:After 24 hours of sequential oxygen therapy,the two groups were statistically different in PaO_(2)/FiO_(2),PaCO_(2),respiratory rate and heart rate(P<0.001).Patients in HFNC group had higher PaO_(2)/FiO_(2)and PaCO_(2)level,yet lower respiratory rate and heart rate than those in common mask group.The re-intubation rates within 48 h were significantly different between groups(P<0.05),and the rate was lower in HFNC group than in common mask group.There was no significant difference in length of EICU stay and mortality between the two groups(P<0.05).Conclusion:Compared with face mask,HFNC can significantly improve oxygenation index and reduce respiratory rate,heart rate and re-intubation rate within 48h in patients with respiratory failure after tracheal extubation.