机械通气拔管后经鼻高流量氧疗序贯治疗在重症肺癌患者中的应用效果

Application effect of sequential nasal high-flow oxygen therapy after mechanical ventilation and extubation in patients with severe lung cancer

目的探讨机械通气拔管后经鼻高流量氧疗序贯治疗在重症肺癌患者中的应用效果。方法根据治疗方式的不同将80例重症肺癌患者分为对照组(n=39)和观察组(n=41),对照组患者机械通气拔管后采用无创正压通气治疗,观察组患者机械通气拔管后给予经鼻高流量氧疗序贯治疗。比较两组患者呼吸频率、心率、恢复指标、血气指标[pH值、脉搏血氧饱和度(SpO_(2))、动脉血二氧化碳分压(PaCO_(2))/吸入气氧浓度(FiO_(2))]、再插管情况和并发症发生情况。结果治疗后2 h,两组患者呼吸频率、心率均低于本组治疗前,观察组患者呼吸频率、心率均低于对照组,差异均有统计学意义(P<0.05)。观察组患者总机械通气时间、重症监护室(ICU)住院时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后12 h,两组患者SpO_(2)均高于本组治疗前,pH值、PaCO_(2)/FiO_(2)均低于本组治疗前,观察组患者SpO_(2)、PaCO_(2)/FiO_(2)均高于对照组,差异均有统计学意义(P<0.05)。观察组患者再插管率为2.44%,与对照组患者的5.13%比较,差异无统计学意义(P>0.05)。观察组患者的并发症总发生率为4.88%,低于对照组患者的23.08%,差异有统计学意义(P<0.05)。结论机械通气拔管后经鼻高流量氧疗序贯治疗可缩短重症肺癌患者的机械通气时间,改善患者的血气指标,促进患者恢复,且安全性较高。

Objective To explore the application effect of sequential nasal high-flow oxygen therapy after mechanical ventilation and extubation in patients with severe lung cancer.Method A total of 80 patients with severe lung cancer were divided into control group(n=39)and observation group(n=41)according to different treatment methods.Among them,the control group was treated with non-invasive positive pressure ventilation after mechanical ventilation and extubation,and the observation group was treated with sequential nasal high-flow oxygen therapy after mechanical ventilation and extubation.The respiratory rate,heart rate,recovery indicators,blood gas indicators[pH value,pulse oxygen saturation(SpO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))/inspired oxygen concentration(FiO_(2))],reintubation status,and incidence of complications were compared between two groups.Result Two hours after treatment,the respiratory rate and heart rate in the two groups were lower than those before treatment,and the respiratory rate,heart rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total mechanical ventilation time and intensive care unit(ICU)stay time of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).Twelve hours after treatment,the SpO_(2) in the two groups were higher than those before treatment,the pH value and PaCO_(2)/FiO_(2) in the two groups were lower than those before treatment,the SpO_(2),PaCO_(2)/FiO_(2) in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The reintubation rate in the observation group was 2.44%,which was not statistically significant compared with 5.13%in the control group(P>0.05).The total incidence of complications in the observation group was 4.88%,which was lower than 23.08%in the control group,and the difference was statistically significant(P<0.05).Conclusion Sequential nasal high-flow oxygen therapy after mechanical ventilation and extubation can shorten the mechanical ventilation time,improve the blood gas indicators of severe lung cancer patients,promote recovery of patients,and have high safety.