摘要
目的探讨间质性肺疾病患者行无创通气治疗的最佳湿化温度。方法选择2015年3月至2016年5月,南京鼓楼医院呼吸科监护室收治的40例间质性肺疾病伴Ⅰ型呼吸衰竭行无创通气的患者为观察对象,无创通气序贯采用三种不同主动湿化温度,分别为常温(过水湿化不加热,22～24℃),低温(31℃),高温(34℃)。比较三组患者主动湿化前、后的痰液黏稠度、患者舒适度,患者口渴情况,血气分析动脉血气氧分压(PaO2)、二氧化碳分压(PaCO_2)、指脉氧饱和度(Sp O2)、呼吸频率(RR)。结果三组患者痰液粘稠度均有改善,差异无统计学意义(P>0.05);患者舒适度观察分为主观舒适度和客观舒适度,三组主观舒适度评价中常温组感觉最佳,常温组与低温组比较差异无统计学意义(P>0.05),高温组与常温组、高温组与低温组比较差异有统计学意义(P<0.05),三种温度下客观舒适度评价中口咽干燥情况比较,差异有统计学意义(P<0.05);三种温度下患者口渴情况中口渴数字评分和喝水需求次数比较,差异有统计学意义(P<0.05);三种温度下患者主动湿化前后的PaO2、RR情况比较,差异无统计学意义(P>0.05),但PaCO_2和Sp O2比较,差异有统计学意义(P<0.05)。结论间质性肺疾病患者行无创通气治疗进行加温加湿,有利于保证患者呼吸道通畅,提高呼吸机使用效能,提高患者无创通气时的舒适度,确定间质性肺疾病患者行无创通气治疗最佳的湿化温度方案为室温与31℃交替选用。
Objective To investigate the best humidified temperatures used in patients with interstitial lung diseases during noninvasive ventilation.Methods Forty cases of type I respiratory failure patients with interstitial lung disease that admitted to the Department of pulmonary and intensive care unit,Nanjing Drum Tower Hospital during March 2015 to May 2016,were investigated in this study.Three different sequentially humidifying temperatures,normal temperature(humidifying without heating,22-24℃),low temperature(31℃),high temperature(34℃)were used.Parameters including sputum viscosity,patient comfort,blood gas analysis including oxygen partial pressure(PaO2)and carbon dioxide partial pressure(PaCO2),pulse oxygen saturation(SpO2)and respiratory rate(RR)before and after humidification were compared among the three temperature.Results Sputum viscosity was improved in the three temperature of patients without statistically significant(P>0.05).The comfort degrees from patients were divided into objective and subjective comfort feeling.Patients using normal temperature reported having the best feeling of subjective comfort evaluation,and there was no difference between the normal and low temperature(P>0.05);and a significant differences was found when high temperature compared to normal temperature or low temperature(P<0.05);objective comfort evaluation including oropharyngeal drying and nasal discomfort had significant differences among three temperature(P<0.05);there was statistical difference for feeling of thirsty and requirement of water among three temp of patients(P<0.05);there was no significant difference(P>0.05)for changes of PaO2 in arterial blood gas analysis,RR before and after humidification among the three temperature;PaCO2 and SpO2 in arterial blood gas analysis was significantly difference between normal temperature before non?invasive ventilation and normal temperature,and the high temperature(P<0.05).Conclusion Heating and humidifying inhalation in patients with interstitial lung disease will help en
作者
高莉
杨文芬
Gao Li;Yang Wenfen(Department of Respiratory,Nanjing Drum Tower Hospital the Affilated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《中华肺部疾病杂志（电子版）》
CAS
2018年第6期703-707,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
间质性肺疾病
湿化温度
舒适度
无创通气
Humidifying temperature
Comfort
Interstitial lung diseases
Noninvasive ventilation
