摘要
目的探讨经鼻高流量氧疗(HFNC)在重症监护室(ICU)肺癌患者拔管后的应用效果。方法根据拔管后给氧方式的不同将94例ICU肺癌患者分为面罩组和鼻高流量组,每组47例,面罩组患者采用储氧面罩给氧,鼻高流量组患者采用HFNC。比较两组患者的血流动力学指标[心率(HR)、平均动脉压(MAP)]、呼吸频率(RR)、血气分析指标[血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]。比较两组患者术后给氧期间的舒适度、对给氧治疗的耐受度、气道湿润度、拔管后进程和再插管情况。结果拔管后12 h,两组患者的RR均低于本组拔管即刻,鼻高流量组患者的HR低于本组拔管即刻,鼻高流量组患者的HR、RR均低于面罩组,差异均有统计学意义(P﹤0.05)。拔管后12 h,两组患者的SpO_(2)、PaO_(2)、PaO_(2)/FiO_(2)均低于本组拔管即刻,鼻高流量组患者的PaCO_(2)低于本组拔管即刻,鼻高流量组患者的SpO_(2)、PaO_(2)、PaO_(2)/FiO_(2)均高于面罩组,PaCO_(2)低于面罩组,差异均有统计学意义(P﹤0.05)。鼻高流量组患者的舒适度评分明显高于面罩组,耐受度、湿润度评分均明显低于面罩组,差异均有统计学意义(P﹤0.01)。鼻高流量组患者的给氧时间、总住院时间均短于面罩组,再插管率低于面罩组,差异均有统计学意义(P﹤0.05)。结论HFNC应用于ICU肺癌患者拔管后可更好地维持其血氧状态,改善呼吸功能,降低再插管率,提高患者对拔管后给氧治疗的耐受度和舒适度,增强气道湿润度。
Objective To investigate the application effect of high-flow nasal cannula oxygen therapy(HFNC)in intensive care unit(ICU)lung cancer patients after extubation.Method A total of 94 patients with lung cancer in ICU were divided into mask group and nasal high-flow group according to the way of oxygen supply after extubation,with 47 cases in each group.The patients in the mask group were given oxygen by oxygen storage masks,and the patients in the nasal high-flow group were given HFNC.The hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP)],respiratory rate(RR),blood gas analysis indicators[saturation of blood oxygen(SpO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen(PaO_(2)/FiO_(2))]were compared between the two groups.Comfort during postoperative oxygen administration,tolerance to oxygen therapy,airway humidity,post-extubation progression,and reintubation were also compared between the two groups.Result Twelve hours after extubation,the RR in the two groups were lower than those immediately after extubation,the HR in the nasal high-flow group was lower than that immediately after extubation,the HR and RR in the nasal high-flow group were lower than those in the mask group,and the differences were statistically significant(P<0.05).Twelve hours after extubation,the SpO_(2),PaO_(2),PaO_(2)/FiO_(2)in the the two groups were lower than those immediately after extubation,the PaCO_(2)in the nasal high-flow group was lower than that immediately after extubation,and the SpO_(2),PaO_(2),PaO_(2)/FiO_(2)in the nasal high-flow group were higher than those in the mask group,the PaCO_(2)was lower than that in the mask group,and the differences were statistically significant(P<0.05).The comfort score of the nasal high-flow group was significantly higher than that of the mask group,and the scores of tolerance and humidity were significantly lower than those of the mask group,and the differences were statistically significant(P<0.01).The oxygen supply time and total hospitalization time in the nasal high-flow group group were shorter than those in the mask group,and the reintubation rate was lower than that in the mask group,and the differences were statistically significant(P<0.05).Conclusion The application of HFNC in ICU patients with lung cancer after extubation could better maintain blood oxygen status,improve respiratory function,and reduce reintubation rate.It could also improve the patient’s tolerance and comfort of oxygen therapy after extubation,and enhance the humidity of the airway.
作者
高爱红
程艳伟
秦历杰
GAO Aihong;CHENG Yanwei;QIN Lijie(Department of Emergency and Critical Care Medicine,He’nan Provincial Key Medicine Laboratory of Nursing,He’nan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2023年第8期877-880,共4页
Oncology Progress
基金
河南省医学科技攻关计划项目(LHGJ20220028)。
关键词
肺癌
拔管后
重症监护室
经鼻高流量氧疗
储氧面罩
lung cancer
post-extubation
intensive care unit
high-flow nasal cannula oxygen therapy
oxygen storage mask
作者简介
通信作者:程艳伟,邮箱:13523065312@163.com。
