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    T管联合文丘里加温湿化氧疗在气管切开脱机病人中的应用

    Application value of T-tube combined with Venturi warm humidifying oxygen therapy in patients with tracheotomy offline

      摘要
    • 摘要:
      目的探讨T管联合文丘里加温湿化氧疗在气管切开脱机病人中的临床应用效果。
      方法选取年龄≥ 18岁的58例气管切开脱机病人，按入院时间先后分为观察组和对照组，其中2018年1-12月收治的30例病人为对照组，2019年1-12月收治的28例病人为观察组。观察组采用T管联合文丘里加温湿化氧疗技术；对照组采用常规气道湿化氧疗。比较2组脱机时和脱机后1、5 d呼吸频率及氧合指数（PaO2/FiO2）、血氧饱和度（SpO2）、动脉血二氧化碳分压（PaCO2）、痰液黏稠度、吸痰次数、吸痰时SpO2下降程度、吸痰时SpO2下降持续时间、ICU滞留时间、并发症发生率情况。
      结果脱机后1、5 d观察组呼吸频率低于对照组，PaO2/FiO2高于对照组（P < 0.01）；脱机后1、5 d观察组痰液黏稠度优于对照组（P < 0.05和P < 0.01）；观察组吸痰次数、吸痰时SpO2下降程度、吸痰时SpO2下降持续时间、ICU滞留时间少于对照组（P < 0.01）；观察组刺激性咳嗽（3.57%）、痰痂形成（0.00%）、肺部感染（0.00%）、气道出血发生率（7.14%）均低于对照组（33.33%、20.00%、20.00%、26.67%）（P < 0.05~P < 0.01）。
      结论文丘里氧疗温湿化法应用于气管切开脱机病人，符合人体温湿化的生理需求，避免了病人的呛咳和不适，可改善痰液黏稠度和呼吸参数，降低并发症的发生，值得临床推广。

       

      Abstract:
      ObjectiveTo investigate the clinical application effects of T-tube combined with Venturi warm humidifying oxygen therapy in patients with tracheotomy offline.
      MethodsFifty-eight patients aged ≥ 18 years old treated with tracheotomy offline were investigated, and divided into the observation group (28 cases, from January to December 2019) and control group (30 cases, from January to December 2018) according to the time of admission. The observation group was treated with T-tube combined with Venturi warm humidifying oxygen therapy, and the control group was treated with conventional airway humidification. The respiratory rate, oxygenation index (PaO2/FiO2), blood oxygen saturation (SpO2), arterial partial pressure of carbon dioxide (PaCO2), viscosity of sputum, times of sputum suction, decline of SpO2 during sputum suction, duration of SpO2 decline during sputum aspiration, ICU residence time and incidence rate of complications were compared between two groups at offline and after 1 and 5 days of offline.
      ResultsAfter 1 day and 5 days of offline, the respiratory rate in observation group was lower than that in control group (P < 0.01), the value of PaO2/FiO2 in observation group was higher than that in control group (P < 0.01), and the sputum viscosity in observation group was better than that in control group (P < 0.05 and P < 0.01). The number of sputum aspiration, decreasing degree of SpO2 during sputum aspiration, decreasing duration of SpO2 during sputum aspiration and ICU stay time in observation group were lower than those in control group (P < 0.01). The incidence rates of irritating cough (3.57%), phlegm scab formation (0.00%), pulmonary infection (0.00%) and airway bleeding (7.14%) ine observation group were lower than those in control group (33.33%, 20.00%, 20.00%, and 26.67%) (P < 0.05 to P < 0.01).
      ConclusionsThe application of Venturi oxygen therapy in patients with tracheotomy offline can meet the physiological needs of human body temperature humidification, avoid the patient's cough and discomfort, improve sputum viscosity and respiratory parameters and reduce the occurrence of complications, and it is worthy of clinical promotion.

       

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