| 张明明.高流量鼻导管改善支气管镜检查患者的氧合状态的评价[J].上海护理,2019,19(10): |
| 高流量鼻导管改善支气管镜检查患者的氧合状态的评价 |
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| DOI： |
| 中文关键词: 鼻高流量、气管镜检查、氧合指数 |
| 英文关键词:Nasal high flow ,bronchoscopy ,oxygenation index |
| 基金项目:上海市卫生计生系统重要薄弱学科建设项目 2015ZB0304 上海交通大学医学院科技基金项目 JYH1605 |
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| 中文摘要: |
| 摘要：目的：通过对高流量鼻导管氧疗系统在支气管镜检查患者中的效果评价，探讨适宜的气管镜检查氧疗决策。方法：近年来，高流量鼻导管已被引入成人氧疗，但迄今为止在成人支气管镜检查中尚未使用。本研究纳入呼吸介入患者60名随机分为三组分别通过文丘里面罩40L/min(V40,n=20)、高流量鼻导管40L /min(N40,n=20)和高流量鼻导管60L/min(N60,n=20)给氧，在检查前静息状态下吸氧10min(t0, FiO2=0.21)、麻醉后10min(t1,FiO2=0.50)、检查结束后10min（t2,FiO2=0.35）,分别采集患者三个时间点的氧合循环指标并记录t0-t2时间段SpO2>95%的时间长度/操作总长的比值、平均心率。结果：t0时刻，V40组、N40组、N60组,患者指标无差异，t1时刻，N60组表现出比V40组和N40组更高的PaO2、PaO2/ FiO2、SpO2，而V40组和N40组之间除心率外其余无差异。t2时刻,N60和V40、N40三组之间的SpO2 是唯一检测到的差异。t0-t2时间段内，N60组的SpO2 >95%的时间长度/操作总长的比值、平均心率明显优于V40组和N40组，N40组和V40组之间无差异。结论：在40L / min的给氧流速下，文丘里面罩和高流量鼻导管在氧合循环的表现上很相似，但后者产生的结果与60L / min流量的结果相关性在临床上更为重要，这一种关联可以在更大程度上保护患有轻度呼吸功能障碍的患者，适宜在后来的气道介入检查中进一步探讨。 |
| 英文摘要: |
| bstract:Objective: To evaluate the effectiveness of bronchoscopy in the treatment of bronchoscopy in patients with high-flow nasal canal oxygen therapy. METHODS: In this study, 60 patients with respiratory intervention were randomly divided into three groups. Oxygen inhalation was given at different rates during bronchoscopy: 40 L/min (V40, n=20) through the venturi, and 40 L/min (N40,n=20) and high-flow nasal cannula 60L/min (N60, n=20) for oxygen, oxygen for 10 min at rest (t0,FiO2=0.21), 10 min after anesthesia (t1,FiO2= 0.50), 10 minutes after the examination (t2, FiO2=0.35), collect the oxygenation cycle index of the patient at three time points and record the time length / operation length of SpO2 > 95% in the t0-t2 time period Ratio, average heart rate. RESULTS: At time t0, there was no difference in patient index between V40 group, N40 group and N60 group. At time t1, N60 group showed higher PaO2, PaO2/ FiO2、,SpO2 than V40 group and N40 group, while V40 group and N40 group There is no difference between the heart rate and the rest.At time t2,SpO2 between the N60 and V40, N40 groups is the only difference detected. In the t0-t2 time period, the ratio of the length of the SpO2 >95%/operation total length and the average heart rate of the N60 group were significantly better than those of the V40 group and the N40 group, and there was no difference between the N40 group and the V40 group. Conclusion: At a flow rate of 40 L / min, the Venturi inner cover and the high flow nasal cannula are similar in oxygenation cycle, but the results of the latter are more clinically correlated with the results of the 60 L/ min flow，Importantly. this association can protect patients with mild respiratory dysfunction to a greater extent,and is suitable for further investigation in subsequent airway interventions. |
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