高流量呼吸湿化治疗仪在程序化撤机中的应用*

Application of high-flow respiratory humidification therapy instrument in programmed weaning process*

摘要:

目的 探讨高流量呼吸湿化治疗仪在程序化撤机中的应用。方法 选取2017年6月—2017年12月温州 医科大学附属第二医院重症监护治疗病房（ICU）行程序化撤机的患者80例，按照其给氧方式意愿分为观察组43例 和对照组37例。观察组给予高流量呼吸湿化治疗仪给氧，对照组给予传统面罩给氧。记录两组患者在使用不同 给氧方式后30 min、2 h和24 h的动脉血氧分压（PaO2）、血氧饱和度（SpO2）、改良英国医学研究会呼吸困难指数 （mMRC）、痰液黏稠度、重新置管率和住院时间。结果 不同时间点的PaO2、SpO2、mMRC 均有差异（P < 0.05）；两组静息状态下PaO2、SpO2、mMRC均有差异（P <0.05），观察组PaO2、SpO2高于对照组，mMRC低 于对照组；两组PaO2、SpO2、mMRC 变化趋势有差异（P <0.05）；给氧后30 min 和给氧后2 h，两组PaO2、 SpO2、mMRC 及痰液黏稠度分级均无差异（P >0.05）；给氧后24 h，观察组PaO2、SpO2均高于对照组（P < 0.05），mMRC低于对照组（P <0.05），痰液黏稠度分级优于对照组（P <0.05）。观察组重新置管率低于对照组 （P <0.05），住院时间短于对照组（P <0.05）。结论 高流量呼吸湿化治疗仪在程序化撤机中的应用效果较好， 值得临床推广使用。

Abstract:

Objective To explore the application of high-flow respiratory humidification therapy instrument in programmed weaning process. Methods Eighty patients who underwent programmed weaning at ICU in the hospital were divided into observation group (43 cases) and control group (37 cases) according to their willingness of oxygen offering methods. The observation group was treated with high-flow respiratory humidification therapy instrument for oxygen offering. The control group was treated with traditional mask oxygen offering method. The arterial partial pressure of oxygen (PaO2), blood oxygen saturation (SpO2), modified british medical research council (mMRC), sputum viscosity, re-cathetering rate, and hospital stays in both groups at 30 min, 2 h and 24 h after different oxygen offering methods given to patients were recorded. Results There were differences in PaO2, SpO2, and mMRC at different time points (P < 0.05). There were differences in PaO2, SpO2, and mMRC between the two groups at resting status (P < 0.05). PaO2 and SpO2 in observation group were higher than those in control group, while mMRC was lower than that in control group. There were differences in changes trend of PaO2, SpO2 and mMRC in the two groups (P <0.05). There was no significant difference in PaO2, SpO2, mMRC or sputum viscosity level between the two groups at 30 min and 2 h after oxygen offering (P >0.05). At 24 h after oxygen offering, PaO2 and SpO2 of the observation group were higher than those of the control group (P < 0.05), while mMRC was lower than that of the control group (P < 0.05), and the sputum viscosity level was better than that of the control group (P < 0.05). The re-cathetering rate of the observation group was lower than that of the control group (P < 0.05), and hospital stays was shorter than that of the control group (P < 0.05). Conclusion The application effect of high-flow respiratory humidification therapy instrument is relatively better in the process of programmed weaning. It is worthy of clinical promotion and application.