呼吸机相关性肺炎应用一次性湿热交换器的预防效果研究

目的:研究分析应用一次性湿热交换器预防呼吸机相关性肺炎的效果。方法:选取重度颅脑外伤住院患者90例,全部患者均构建人工气道,以随机数字法将其划分成研究组与对照组,两组患者例数均为45例,研究组患者应用一次性湿热交换器,对照组患者应用常规湿化,对比分析两组患者1 h后气道内平均温度、湿化满意度、多重耐药菌感染率以及呼吸机相关性肺炎发生率。结果:和对照组相比较,研究组1 h后气道内平均温度(26.2±1.3℃)和湿化满意度(93.3%)均比较高,同时多重耐药菌感染率(4.4%)和呼吸机相关性肺炎发生率(2.2%)少,组间数据比较差异显著,具有统计学意义(P<0.05)。结论:经研究结果的分析可知,对于机械通气患者应用一次性湿热交换器,可预防和减少呼吸机相关性肺炎和多重耐药菌感染的的发生,同时还可提高患者湿化满意度,有利于治疗效果和预后的改善,值得应用与推广。     

52例非机械通气人工气道患者气道湿化的护理体会

目的总结52例带有人工气道患者非机械通气时气道湿化的护理体会。方法持续气道加温湿化;充分补充水分,保证液体平衡;加强基础护理及心理护理;严密观察病情,准确评估湿化效果。结果 52例患者中有3例出现湿化过度,改为间断湿化。均无气道阻塞、出血、痰痂形成,湿化效果满意。结论对非机械通气人工气道患者气道湿化时采取正确的护理方法,可提高湿化效果,避免并发症的发生。     

围术期氧气雾化护理干预在老年患者全身麻醉腹部手术中的应用

目的 探究在老年患者全身麻醉腹部手术的过程中,应用围术期氧气雾化护理干预的效果.方法 方便选取46例老年全身麻醉腹部手术患者进行围术期氧气雾化护理干预,并归为观察组,选取另外40例患者采用常规干预,并归为对照组,两组患者均为该院2013年2月—2016年5月间收治.结果 针对性比较两组患者的咳嗽咳痰发生率发现,观察组患者30.43%明显较低(对照组为47.50%);针对性比较两组患者的咳嗽咳痰轻重程度发现,观察组患者相对较轻,观察组轻度所占比例为50.00%,对照组仅为26.31%;针对性比较两组患者的肺部感染发生率发现,观察组发生率23.91%相对较低(对照组为40.00%),组间比较差异有统计学意义(P<0.05).结论 围术期氧气雾化护理干预在老年患者全身麻醉腹部手术中的应用发现,其能够帮助患者临床情况得到较好的改善,同时减少患者出现相应的不良事件,促进患者及时恢复,因此值得临床借鉴.     

经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.     

高流量吸氧与面罩吸氧在胸腔镜辅助食管癌根治术后氧疗效果对比

目的观察高流量湿化吸氧与常规面罩吸氧在食管癌患者行胸腔镜辅助食管癌根治术后治疗的临床效果。方法将36例择期行胸腔镜辅助下食管癌根治术后患者随机分为常规面罩吸氧对照组(A组)和高流量湿化吸氧治疗组(B组),对两组患者治疗2 h、6 h和24 h后的呼吸频率、动脉血气分析等指标进行比较,了解两种吸氧方式在食管癌患者行胸腔镜辅助食管癌根治术后治疗上的优劣。结果两组患者治疗2 h、6 h和24 h的呼吸频率、动脉血气分析发现,A组动脉氧饱和度、动脉血氧分压较B组降低,动脉血二氧化碳分压、呼吸频率较B组增高,两组比较差异有统计学意义(均P0.01)。结论与常规面罩吸氧比较,高流量湿化面罩吸氧可以使胸腔镜辅助食管癌根治术后患者有更满意的氧合效果,值得在临床上推广。     

现代人，为什么会缺氧

在地球的大气中，原始没有氧气。最初的氧气是水气受到光照，水分子被光解，以及水中绿色植物的光合作用而产生。当时。地球表面的氧气还很少。直到大约3亿年前，地球上绿色植物增加，使大气中的氧气不断增量，逐步达到近代大气氧含量水平（21％）。     

食管切除病人术后雾化吸入方式改进的临床观察

目的:探讨适用于食管切除术后病人更理想的雾化吸入方案,以促进病人有效排痰,预防术后肺部并发症.方法:选择重庆医科大学附属第一医院胸心外科2008年1月～6月行全麻开胸食管切除食管胃弓上吻合病人60例,随机分为2组,实验组采用0.45%氯化钠作为湿化剂持续24 h氧气雾化吸入,对照组采用0.9%氯化钠作为湿化剂行氧气雾化吸入4次/d.15min/次,并根据痰液的黏稠度增加雾化吸入次数.结果:两组病人在使用氧气雾化吸入后血气分析结果提示pH、PO2、PCO2值之间差异无统计学意义(P>0.05),实验组湿化适中例数多于对照组有统计学差异(P<0.01),湿化不足例数小于对照组有统计学差异(P<0.01),湿化过度例数无统计学差异(P>0.05).结论:食管切除术后病人采用0.45%氯化钠早期、持续氧气雾化吸入不仅降低痰液的黏弹性.还可维持血中氧分压的稳定.     

氧气疗法的临床应用

<正>氧气疗法是借助于提高吸入气体中氧浓度来提高血氧分压,从而纠正或缓解缺氧状态,是治疗缺氧的一种手段。正确合理地使用氧气疗法可使许多患者因缺氧引起的一系列生理紊乱得到改善或缓解,提高