经鼻高流量湿化氧疗系统对急性脑外伤术后气管插管拔管后再插管率的影响
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摘要
目的观察经鼻高流量湿化氧疗系统对急性脑外伤术后患者气管插管拔管后再插管率的影响。方法选择急性脑外伤手术后撤离呼吸机拔除气管导管的患者68例,按随机数字表分为对照组和观察组各34例,对照组患者在脱机拔管后采用常规面罩吸氧方式,观察组采用经鼻高流量湿化氧疗系统;比较两组患者的RR、SpO_2、PaO_2、PaCO_2等指标及再插管率。结果两组患者脱机拔管接受氧疗后不同时间RR、SpO_2、PaO_2、PaCO_2比较,差异均有统计学意义(P<0.01);观察组的再插管率0%(0/34),对照组为8.82%(3/34),差异无统计学意义(P>0.05)。结论对于急性脑外伤术后气管插管脱机拔管后的氧疗,经鼻高流量湿化氧疗系统相比于传统的面罩氧疗效果更佳,在一定程度上能降低再插管率。
引文
[1]刘士敏.急性脑外伤手术患者综合护理的效果研究[J].中国急救医学,2016,36(11):244-245.
[2]LEE J H,REHDER K J,WILLIFORD L,et al.Use of high flow nasal cannula in critical ill infants,children,and adults:a critical review of the literature[J].Intersive Care Med,2013,39(2):247-257.
[3]陆青梅.吸氧面罩作气管切开保护罩的护理干预[J].中外健康文摘,2013,11(27):257.
[4]邓坤,郭闯.经鼻高流量吸氧对气管插管患者脱机拔管后再插管率的影响[J].中国实用护理杂志,2016,32(34):2684-2686.
[5]SZTRYMF B,MESSIKA J,MAYOT T,et al.Impact of highflow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure:aprospective observational study[J].Crit Care,2012,27(3):324.
[6]CARRATALPERALES J M,LLORENS P,BROUZET B,et al.High-Flow therapy via nasal cannula in acute heart failure[J].Rev Esp Cardiol,2011,64(8):723-725.
[7]YOO J W,SYNN A,HUH J W,et al.Clinical efficacy of highflow nasal cannula compared to noninvasive ventilation in patients with post-extubation respiratory failure[J].Korean JIntern Med,2016,31(1):82-88.
[8]ROCA O,RIERA J,TORRES F,et al.High-flow oxygen therapy in acute respiratory failure[J].Respir Care,2010,55(4):408-413.
[9]崔彦芹,周娜,王燕飞,等.经鼻高流量湿化氧疗治疗先天性心脏病术后呼吸衰竭的有效性研究[J].中国呼吸与危重监护杂志,2012,5(11):231-234.
[10]REIS H F,ALMEIDA M L,SILVA M F,et al.Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury[J].Bras Pneumol,2013,39(3):330-338.
[11]KAPNADAK S G,HERNDON S E,BURNS S M,et al.Clinical outcomes associated with high,intermediate,and low rates of failed extubation in an intensive care unit[J].Journal of Critical Care,2015,30(3):449-454.
[12]KRINSLEY J S,REDDY P K,IQBAL A.What is the optimal rate of failed extubation[J].Critical Care,2012,16(1):111.
[13]BROTFAIN E,ZLOTNIK A,SCHWARTZ A,et al.Comparison of the effectiveness of high flow nasal oxygen cannula vs.standard non-rebreather oxygen face mask in post-extubation intensive care unit patients[J].Isr Med Assoc J,2014,16(11):718-722.
[14]MAGGIORE S M,IDONE F A,VASCHETTO R,et al.Nasal high-flow versus Venturi mask oxygen therapy after extubation.Effects on oxygenation,comfort,and clinical outcome[J].Am J Respir Crit Care Med,2014,190(3):282-288.
[2]LEE J H,REHDER K J,WILLIFORD L,et al.Use of high flow nasal cannula in critical ill infants,children,and adults:a critical review of the literature[J].Intersive Care Med,2013,39(2):247-257.
[3]陆青梅.吸氧面罩作气管切开保护罩的护理干预[J].中外健康文摘,2013,11(27):257.
[4]邓坤,郭闯.经鼻高流量吸氧对气管插管患者脱机拔管后再插管率的影响[J].中国实用护理杂志,2016,32(34):2684-2686.
[5]SZTRYMF B,MESSIKA J,MAYOT T,et al.Impact of highflow nasal cannula oxygen therapy on intensive care unit patients with acute respiratory failure:aprospective observational study[J].Crit Care,2012,27(3):324.
[6]CARRATALPERALES J M,LLORENS P,BROUZET B,et al.High-Flow therapy via nasal cannula in acute heart failure[J].Rev Esp Cardiol,2011,64(8):723-725.
[7]YOO J W,SYNN A,HUH J W,et al.Clinical efficacy of highflow nasal cannula compared to noninvasive ventilation in patients with post-extubation respiratory failure[J].Korean JIntern Med,2016,31(1):82-88.
[8]ROCA O,RIERA J,TORRES F,et al.High-flow oxygen therapy in acute respiratory failure[J].Respir Care,2010,55(4):408-413.
[9]崔彦芹,周娜,王燕飞,等.经鼻高流量湿化氧疗治疗先天性心脏病术后呼吸衰竭的有效性研究[J].中国呼吸与危重监护杂志,2012,5(11):231-234.
[10]REIS H F,ALMEIDA M L,SILVA M F,et al.Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury[J].Bras Pneumol,2013,39(3):330-338.
[11]KAPNADAK S G,HERNDON S E,BURNS S M,et al.Clinical outcomes associated with high,intermediate,and low rates of failed extubation in an intensive care unit[J].Journal of Critical Care,2015,30(3):449-454.
[12]KRINSLEY J S,REDDY P K,IQBAL A.What is the optimal rate of failed extubation[J].Critical Care,2012,16(1):111.
[13]BROTFAIN E,ZLOTNIK A,SCHWARTZ A,et al.Comparison of the effectiveness of high flow nasal oxygen cannula vs.standard non-rebreather oxygen face mask in post-extubation intensive care unit patients[J].Isr Med Assoc J,2014,16(11):718-722.
[14]MAGGIORE S M,IDONE F A,VASCHETTO R,et al.Nasal high-flow versus Venturi mask oxygen therapy after extubation.Effects on oxygenation,comfort,and clinical outcome[J].Am J Respir Crit Care Med,2014,190(3):282-288.