| 施俊,仝婕,张楚彬,楚青,张炜,邵凌云.重症肺炎患者呼吸道管理策略探讨[J].上海护理,2022,22(8): |
| 重症肺炎患者呼吸道管理策略探讨 |
| The discussion of airway management strategies in patients with severe pneumonia |
| DOI： |
| 中文关键词: 重症肺炎 肺部感染 经鼻导管高流量湿化氧疗 CURB-65评分 预后 |
| 英文关键词:High-flow nasal cannula (HFNC) humidification oxygen therapy Pulmonary infections Severe pneumonia CURB-65 score Prognosis |
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| 中文摘要: |
| 摘要：目的 通过评估经鼻导管高流量湿化氧疗在肺部感染患者中的临床疗效，为肺部感染尤其是重症肺炎的患者呼吸道管理策略提供一定的参考依据。方法 2015年9月至2017年9月，采用方便抽样方法选取收治于复旦大学附属华山医院感染科的375例肺部感染患者作为研究对象。依据时间将2015年9月1日至2016年8月31日、2016年9月1日至2017年8月31日入院的患者分别纳入对照组和观察组，对照组患者接受常规治疗，观察组患者在对照组的基础上根据病情接受经鼻导管高流量湿化氧疗。比较两组患者的住院时长、气管插管（包括无创/有创气管切开）人数比例以及预后转归。在对照组和观察组的重症肺炎患者中评估接受经鼻导管高流量湿化氧疗的患者预后情况。结果 观察组重症肺炎的患者比例较对照组高，预后较对照组好，均有统计学差异（P < 0.05）。与未使用HFNC治疗的患者比较，发现接受HFNC的重症肺炎患者预后更好，有统计学差异（P < 0.05）。使用HFNC治疗后，重症肺炎患者的多个指标如呼吸频率、心率、氧饱和度、氧分压均有显著改善，均有统计学差异（P < 0.05）。结论 近年来，我院感染科收治患者的肺部感染患者人数越来越多，重症化比例也越来越高。在此情况下，医院的管理、医生的诊疗、护士的护理到位，使整体肺部感染患者的住院天数、预后转归与既往病情较轻的时候并无差异。同时，接受HFNC的重症肺炎患者，预后明显好转，表明HFNC对改善肺部感染患者预后有明显疗效。 |
| 英文摘要: |
| Abstract：Objective By evaluating the clinical efficacy of high-flow nasal cannula (HFNC) humidification oxygen therapy in patients with pulmonary infection, some references of airway management strategies are provided for patients with pulmonary infection, especially severe pneumonia. Methods From September 2015 to September 2017, 375 patients with pulmonary infection admitted to the Department of Infectious Diseases, Huashan Hospital Affiliated to Fudan University, were selected by convenience sampling. The control group was from September 1, 2015 to August 31, 2016, while the observation group was from September 1, 2016 to August 31, 2017. The patients in the control group received conventional treatment, and the patients in the observation group were given HFNC treatment according to clinical needs on the basis of conventional treatment. The period of hospitalization, the proportion of intubated patients, and the prognosis of patients were compared between the two groups. The prognosis of patients receiving HFNC was evaluated in patients with severe pneumonia in the control and observation groups. Results Although the proportion of patients with severe pneumonia in the experimental group was higher than that in the control group, the prognosis was better than that in the control group, both with statistical difference (P < 0.05). Patients of severe pneumonia treated with HFNC in two groups were selected to evaluate the prognosis. Comparing with patients treated without HFNC, the prognosis of patients with severe pneumonia treated with HFNC was better (P < 0.05). Additionally, multiple indicators of patients with severe pneumonia, such as respiratory rate, heart rate, oxygen saturation, and partial pressure of oxygen, were significantly improved after HFNC treatment, with statistical differences (P < 0.05). Conclusion In recent years, the number of patients with pulmonary infection in the Department of Infectious Diseases of our hospital has increased, and the proportion of severe cases has also increased. Under this circumstance, the hospital's management, the doctors' diagnosis and treatment, and the nurses' caring are in place, so that the overall length of hospitalization and prognosis of patients with pulmonary infection do not show difference from those milder ones in the past. At the same time, the prognosis of patients with severe pneumonia treated with HFNC was significantly improved, indicating that HFNC has a significant effect on improving the prognosis of patients with pulmonary infection. |
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