| 于利国,王博,马艳,刘金明,李艳芳,孙瑞.高流量氧疗联合俯卧位通气在脑卒中后气管切开非机械通气患者拔管中的应用[J].中国康复,2025,40(9):530-534 |
| 高流量氧疗联合俯卧位通气在脑卒中后气管切开非机械通气患者拔管中的应用 |
| Application of high-flow oxygen therapy combined with prone position ventilation strategy in extubation of stroke patients with tracheotomy and non-mechanical ventilation |
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| DOI：10.3870/zgkf.2025.09.004 |
| 中文关键词: 气管切开 高流量湿化 俯卧位通气 拔管 |
| 英文关键词: tracheotomy high-flow oxygen therapy prone position ventilation extubation |
| 基金项目:武汉市卫健委医学科研项目(WX21Q19) |
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| 中文摘要: |
| 目的：观察高流量氧疗联合俯卧位通气策略在脑卒中后气管切开非机械通气患者拔管中的临床疗效。方法：脑卒中后气管切开非机械通气患者52例，随机分为观察组18例、对照A组17例、对照B组17例，观察组拔管策略为高流量氧疗+俯卧位通气，对照A组为常规氧疗+俯卧位通气，对照B组为高流量氧疗+常规体位管理。分别记录3组患者拔管中位时间、拔管前每日平均排痰量和痰液性状、拔管前后临床肺部感染评分、肺功能及拔管前后吞咽功能。结果：观察组拔管中位时间为9d，显著短于对照A组和对照B组（P＜0.05）；观察组及对照组A拔管成功率高于对照组B（P＜0.05）；3组患者拔管后临床肺部感染评分均低于拔管前（P＜0.05），且观察组低于对照A组和对照B组（P＜0.05）；观察组拔管前每日平均排痰量高于对照A组和对照B组（P＜0.05），拔管后，观察组痰液性状分级、肺功能评分及才藤氏吞咽障碍等级均较对照A组和对照B组明显提高（P＜0.05）。结论：高流量氧疗联合俯卧位通气策略可以缩短脑卒中患者拔管时间，改善痰液性状、吞咽功能及肺功能。 |
| 英文摘要: |
| Objective: To observe the clinical efficacy of high-flow oxygen therapy combined with prone position ventilation strategy in extubation of tracheotomized non-mechanical ventilation patients after stroke. Methods: 52 patients with post-stroke tracheotomy non-mechanical ventilation were randomly divided into 18 cases in the observation group, 17 cases in the control A group, and 17 cases in the control B group. The extubation strategy of the observation group was high-flow oxygen therapy + prone position ventilation, that of the control A group was conventional oxygen therapy + prone position ventilation, and that of the control B group was high-flow oxygen therapy + conventional postural management. The median time of extubation, average daily sputum volume and sputum character before extubation, clinical lung infection score before and after extubation, pulmonary function and swallowing function before and after extubation were recorded in the three groups, respectively. Results: The median time to extubation in the observation group was 9 d, which was significantly shorter than that in control group A and control group B (P<0.05); the success rate of extubation in the observation group and control group A was higher than that in control group B (P<0.05); the clinical lung infection scores of the patients in the three groups after extubation were lower than that before extubation (P<0.05), and in the observation group, they were lower than that in control group A and control group B (P<0.05); the average daily sputum volume and character of sputum discharge before extubation were higher than that of control group A and control group B (P<0.05); and the mean daily sputum volume and character of sputum discharge before extubation were higher than that of control group A and control group B. The average daily sputum volume before extubation was higher than that of control group A and control group B (P<0.05), and after extubation, the sputum character grading, pulmonary function score and Saeto's dysphagia grade of the observation group were significantly higher than that of control group A and control group B (P<0.05). Conclusion: High-flow oxygen therapy combined with prone ventilation strategy can shorten the extubation time and improve sputum properties, swallowing function and lung function in stroke patients. |
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