摘要
目的:观察高流量氧疗治疗轻中度呼吸衰竭的效果及安全性。方法:将90例轻中度呼吸衰竭患者按入ICU后首次使用的呼吸支持方式及时间分为观察组(n=47)与对照组(n=43)。观察组经鼻高流量氧疗(HFNC)治疗,对照组采用无创通气(NIV)治疗,比较入ICU时病情、治疗情况及入ICU时、初治治疗24h时的呼吸频率、PaCO2、氧合指数、治疗结局及治疗失败率、失败原因。结果:两组发病至ICU时间、入ICU时病情、总呼吸支持时间等比较差异无统计学意义;但观察组气道护理次数显著低于对照组(P<0.05)、入ICU初始治疗24h内治疗时间显著长于对照组(P<0.05);且初始治疗24h时两组呼吸频率、PaCO2、氧合指数较入ICU时均有显著改善,但组间比较差异无统计学意义(P>0.05);两组有创通气率、28d病死率及ICU住院时间、总住院时间、治疗失败率比较差异均无统计学意义(P>0.05),但观察组鼻面部损伤、不耐受发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:高流量氧疗治疗轻中度呼吸衰竭患者的效果与无创通气相当,但前者或具更低的面部损伤发生率及更佳的耐受性。
Objective:To observe the effect and safety of high-flow oxygen therapy in patients with mild to moderate respiratory failure.Methods:90 patients with mild to moderate respiratory failure were divided into observation group(n=47)and control group(n=43)according to the respiratory support method and time of the first use after ICU admission.The observation group was treated with high-flow nasal cannula oxygen therapy(HFNC),and the control group was treated with non-invasive ventilation(NIV).The condition and treatment at admission to ICU,respiratory rate at admission to ICU and at initial treatment for 24 hours,PaCO2,oxygenation index,treatment outcome,treatment failure rate and causes were compared.Results:There was no significant difference between the two groups in the time from onset to ICU,the condition at admission to ICU and total respiratory support time.However,the number of airway care in the observation group was significantly smaller than that in the control group(P<0.05).The treatment time of the observation group in 24 hours after admission to ICU was significantly longer than that of the control group(P<0.05).The respiratory rate,PaCO2 and oxygenation index of both groups were significantly improved at initial treatment for 24 hours,without significant difference between two groups(P >0.05).There was no significant difference between the two groups in invasive ventilation rate,28-day mortality rate,length of stay in ICU,total hospitalization time and treatment failure rate(P>0.05).The incidence rates of nasal and facial injuries and intolerance in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:The effect of high-flow oxygen therapy on patients with mild to moderate respiratory failure is comparable to that of NIV,but the former may have a lower incidence of facial injuries and better tolerance.
作者
徐文斌
赵海莲
XU Wenbin;ZHAO Hailian(Department of Critical Care Medicine,Longchang People’s Hospital,Sichuan Province,Longchang 642150)
出处
《陕西医学杂志》
CAS
2020年第3期296-299,共4页
Shaanxi Medical Journal
基金
四川省卫生和计划生育委员会科研课题(101589421).
关键词
高流量氧疗
轻中度呼吸衰竭
安全性
无创通气
High-flow oxygen therapy
Mild to moderate respiratory failure
Safety
Non-invasive ventilation
