|本期目录/Table of Contents|

[1]刘月娥,张宇豪,刘锐,等.经鼻高流量序贯治疗对脓毒症机械通气患者的预后影响[J].医学研究与战创伤救治(原医学研究生学报),2022,24(4):341-344.[doi:10.3969/j.issn.1672-271X.2022.04.002]
　LIU Yue-e,ZHANG Yu-hao,LIU Rui,et al.Effect of high-flow nasal oxygen cannula therapy on the prognosis of patients with mechanical ventilation of sepsis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):341-344.[doi:10.3969/j.issn.1672-271X.2022.04.002]
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经鼻高流量序贯治疗对脓毒症机械通气患者的预后影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年4期
页码:
341-344
栏目:
临床研究
出版日期:
2022-08-30

文章信息/Info

Title:
Effect of high-flow nasal oxygen cannula therapy on the prognosis of patients with mechanical ventilation of sepsis
作者:
刘月娥; 张宇豪; 刘锐; 王蒙蒙; 张炜; 杨志洲
作者单位：210002南京，南京医科大学金陵临床医学院（东部战区总医院）急诊医学科（刘月娥、张宇豪、刘锐、王蒙蒙、张炜、杨志洲）
Author(s):
LIU Yue-e; ZHANG Yu-hao; LIU Rui; WANG Meng-meng; ZHANG Wei; YANG Zhi-zhou
（Department of Emergency Medicine，Jinling Hospital，Nanjing Medical University/General Hospital of Eastern Theater Command, PLA, Nanjing 210002,Jiangsu,China）
关键词:
脓毒症; 经鼻高流量; 无创通气; 机械通气
Keywords:
sepsis; nasal high flow; noninvasive ventilation; mechanical ventilation
分类号:
R459.7
DOI:
10.3969/j.issn.1672-271X.2022.04.002
文献标志码:
A
摘要:
目的探讨经鼻高流量序贯治疗在脓毒症机械通气患者中的应用效果。方法回顾性分析2019年6月-2021年12月东部战区总医院急诊重症监护室收治的脓毒症机械通气患者78例的临床资料，据患者脱机后序贯治疗方式将患者分为经鼻高流量吸氧（HFNC）组（n=36）和无创辅助通气（NIV）组（n=42），分别统计分析2组患者基线资料以及72 h内再插管率、ICU内再插管率、ICU内死亡率、28 d死亡率、ICU住院时间情况和总住院时间，并分析比较2组患者ICU内再插管的原因。结果HFNC组与NIV组患者的再插管率、死亡率、住院时间比较差异统计学均无统计学意义（P>0.05）。Kaplan-Meier法分析显示2组患者拔管后的累积再插管的可能性差异无统计学意义（log-rank P=0.770）。2组患者再插管病因最常见的为低氧血症，NIV组和HFNC组分别为58.33%和54.55%，NIV组的咳痰障碍发生率高于HFNC组（25.00% vs 18.18%，P<0.05）。NIV组患者不良耐受发生明显高于HFNC组（0 vs 19.05%，P<0.05）。结论对于脓毒症机械通气患者，与NIV相比，HFNC序贯脱机治疗不增加患者再插管率及其他不良预后发生，且具有较好的耐受性。
Abstract:
ObjectiveTo investigate the effect of high-flow nasal oxygen cannula（HFNC） therapy in patients with mechanical ventilation of sepsis.MethodsA total of 78 patients with mechanical ventilation of sepsis admitted to the emergency intensive care unit of our hospital were retrospectively analyzed. The patients were divided into HFNC group (n=36) and None invasive Ventilation (NIV) group (n=42) according to sequential therapy after weaning. The baseline data, reintubation rate within 72 h, ICU reintubation rate, ICU mortality, 28-day mortality, length of stay in ICU and total length of hospital stay of patients in the two groups were statistically analyzed, and the causes of reintubation of the patients in the two groups were analyzed and compared.ResultsThere were no significant differences in reintubation rate, mortality rate and length of hospital stay between HFNC group and NIV group (P>0.05). Kaplan-meier analysis showed that there was no significant difference in the cumulative possibility of intubation after extubation between the two groups (log-rank P=0.770). The most common cause of reintubation in the two groups was hypoxemia, 58.33% of NIV and 54.55% of HFNC, respectively. The incidence of expectoration disorder in NIV group was higher than that in HFNC group (25.00% vs 18.18%，P<0.05). The incidence of intolerance in NIV group was significantly higher than that in HFNC group (0 vs 19.05%, P<0.05).ConclusionCompared with NIV, sequential weaning with HFNC does not increase the rate of reintubation and other adverse outcomes in patients with mechanical ventilation of sepsis, and is well tolerated.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81701894,82102311）
更新日期/Last Update: 2022-09-06