重症监护室肺癌患者拔管后经鼻高流量氧疗与储氧面罩吸氧有效性的比较
秦欢, 穆盛田, 郑振中国医科大学肿瘤医院, 辽宁省肿瘤医院重症监护室, 沈阳 110042
收稿日期:
2019-06-28出版日期:
2020-04-30发布日期:
2020-04-18通讯作者:
郑振E-mail:zhengzhen@cancerhosp-ln-cmu.com作者简介:
秦欢(1989-),女,主治医师,硕士.基金资助:
沈阳市科技计划(17-230-9-79)关键词: 肺癌, 机械通气, 拔管, 经鼻高流量氧疗, 储氧面罩
Abstract: Objective To compare the efficacies of postextubation high-flow nasal cannula oxygen (HFNC) and oxygen masks in patients with lung cancer in the intensive care unit (ICU). Methods This prospective study included 62 patients with lung cancer admitted to the ICU who passed the spontaneous breathing trial. The patients were divided into groups A (receiving an HFNC,n=32) and B (receiving an oxygen mask,n=30). Data on heart rate,mean arterial pressure,respiratory rate,blood oxygen saturation,inhaled oxygen concentration,arterial blood gas analysis,duration of mechanical ventilation,number of reintubations required,length of stay in the ICU,and ICU mortality were recorded before as well as 1 and 12 h after extubation. Results A significant difference was noted in PaO2/FiO2 between the two groups before as well as 1 and 12 h after extubation (P<0.05). PaO2 and PaO2/FiO2 were significantly higher in group A than in group B 12 h after extubation (P<0.05). Fewer patients required reintubation in group A than in group B (P<0.05). No significant difference was noted in hemodynamics,duration of mechanical ventilation,length of stay in the ICU,and ICU mortality between the two groups. Conclusion HFNC use can raise PaO2/FiO2;reduce the risk of reintubation;and improve airway humidification,comfort,and tolerance for the patients.
Key words: lung cancer, mechanical ventilation, extubation, high-flow nasal cannula oxygen, oxygen mask
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