急危重症患者急性Ⅱ型呼吸衰竭脱机时续贯使用无创正压通气和经鼻高流量湿化氧疗的效果比较

Effect Comparison of Sequential Therapy of Non-Invasive Positive Pressure Ventilation and High-Flow Nasal Cannula Oxygen Therapy in Critically Ill Patients with Acute TypeⅡRespiratory Failure After Ventilator Taken Offline

目的比较无创正压通气与经鼻高流量湿化氧疗在急危重症患者急性Ⅱ型呼吸衰竭脱机后续贯治疗的临床效果。方法选取医院2020年3月至2021年12月收治的急危重症急性Ⅱ型呼吸衰竭患者64例,按随机数字表法分为对照组和研究组,各32例。患者有创呼吸机辅助通气脱机后,对照组采用无创正压通气续贯治疗,研究组采用经鼻高流量湿化氧疗续贯治疗,均治疗3 d。比较两组的疗效。结果研究组患者实施经鼻高流量湿化氧疗后,血气指标较治疗前改善,且较对照组更好(P<0.05);临床症状改善用时比较,研究组症状改善所耗时间较短(P<0.05);不良事件发生率、再次插管率比较,研究组低于对照组(P<0.05);生命体征比较,研究组患者比对照组患者更稳定(P<0.05)。结论急危重症患者急性Ⅱ型呼吸衰竭脱机时,经鼻高流量湿化氧疗、无创正压通气均能满足患者的氧气供给,但经鼻高流量湿化氧疗的效果更好。

Objective To compare the clinical efficacy of sequential therapy of non-invasive positive pressure ventilation and high-flow nasal cannula oxygen therapy(HFNC)in critically ill patients with acute typeⅡrespiratory failure after ventilator was taken offline.Methods A total of 64 critically ill patients with acute typeⅡrespiratory failure admitted to the hospital from March 2020 to December 2021 were selected and divided into the control group and the study group by the random number table method,with 32 cases in each group.After the assisted ventilation of invasive ventilator was taken offline,the control group received non-invasive positive pressure ventilation for sequential therapy,while the study group received HFNC for sequential therapy.Both groups were treated for 3 d.The clinical efficacy of the two groups were compared.Results After implementing HFNC,the blood gas indicators in the study group were better than those before treatment,and those in the control group(P<0.05).The improvement time of clinical symptoms in the study group was significantly shorter than that in the control group(P<0.05).The incidence of adverse events and reintubation rate in the study group were significantly lower than those in the control group(P<0.05).The vital sign in the study group were more stable than that in the control group(P<0.05).Conclusion After the invasive ventilator was taken offline,HFNC and non-invasive positive pressure ventilation can meet the oxygen supply of critically ill patients with acute typeⅡrespiratory failure,but the effect of HFNC is better.