湿化经鼻高流量氧疗对肺癌手术患者呼吸功能的影响

目的:探讨湿化经鼻高流量氧疗对肺癌根治术后患者呼吸功能的影响。方法:选取我院2016年 5月至 2018年4月实施的肺癌根治术患者112例。使用随机数字法分为对照组和观察组，每组各56例。对照组:气管插管脱机后常规文丘里面罩吸氧，观察组:行HFNC。结果:两组氧合指数、PaO2、PaCO2在吸氧前差异无统计学意义（P＞0.05），吸氧24 h后观察组氧合指数和PaO2为348.15±46.43和（88.91±15.27）mmHg，显著高于对照组的307.54±40.22和（78.13±13.05）mmHg（P＜0.05），观察组PaCO2为（32.16±4.24）mmHg，显著低于对照组的（40.13±6.51）mmHg（P＜0.05）。观察组舒适度评分、耐受性评分、气道湿化情况评分分别为(1.54±0.26)分、(1.23±0.21)分和(1.88±0.16)分，均显著低于对照组的(2.72±0.43)分、(2.87±0.36)分和(2.92±0.54)分（P＜0.01）。观察组再次插管机械通气率和CAM-ICU阳性率分别为8.9%（5/56）和5.4%（3/56），显著低于对照组的21.4%（12/56）和14.3%（8/56）（P＜0.05）。观察组住院时间为（13.42±2.13）d，显著短于对照组的（16.23±2.75）d（P＜0.05）。结论:湿化经鼻高流量氧疗可以显著改善肺癌根治术后患者呼吸功能，有利于患者术后的恢复。

Effect of humidified high-flow nasal cannula oxygen therapy on respiratory function after radical resection of lung cancer

Objective:To detect the effect of humidified high-flow nasal cannula oxygen therapy(HFNC) on respiratory function after radical resection of lung cancer.Methods:112 patients after radical resection of lung cancer were enrolled in this study.They were divided into control group(n=56) and observation group(n=56).The control group was given oxygen inhalation in conventional mound.The observation was given HFNC.Results:There was no significant difference in oxygenation index,PaO2 and PaCO2 between the two groups before oxygen inhalation (P＞0.05).After oxygen inhalation for 24 h,oxygenation index and PaO2 in observation group was 348.15±46.43 and （88.91±15.27）mmHg，which was significantly higher than that of 307.54±40.22 and （78.13±13.05）mmHg in control group (P＜0.05).PaCO2 was （32.16±4.24）mmHg in observation group，which was lower than that of （40.13±6.51）mmHg in control group（P＜0.05）.The scores of comfort grade,tolerance and airway humidification score in observation group were 1.54±0.26,1.23±0.21,and 1.88±0.16,which were significantly lower than that of 2.72±0.43,2.87±0.36,and 2.92±0.54 in control group (P＜0.01).The mechanical ventilation rate and CAM-ICU positive rate in observation group were 8.9% (5/56) and 5.4% (3/56),which were significantly lower than that of 21.4% (12/56) and 14.3% (8/56) in control group (P＜0.05).The length of hospital stay in observation group was （13.42±2.13）d,which was significantly shorter than that of （16.23±2.75）d in control group (P＜0.05).Conclusion:HFNC can significantly improve respiratory function of patients after radical resection of lung cancer,which is conducive to postoperative recovery.