目的 探讨鼻氧管、氧气面罩和氧袋面罩三种吸氧方法治疗重型病毒性肺炎患者的临床效果.方法 113 例重型病毒性肺炎患者为研究对象,其中,32 例接受鼻氧管吸氧氧疗(鼻氧管组),40 例接受氧气面罩吸氧氧疗(氧气面罩组),41 例接受氧袋面罩吸氧氧疗(氧袋面罩组).对比三组患者吸氧治疗前后的血气分析监测结果[pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)、血氧饱和度(SpO2)],OI<300 mm Hg(1 mm Hg=0.133 kPa)持续时间、治疗有效率及气管插管率.结果 治疗前,三组患者的pH值、PaO2、PaCO2、OI、SpO2 对比,差异无统计学意义(P>0.05).氧袋面罩组治疗 48 h后的pH值高于本组治疗前,差异具有统计学意义(P<0.05);氧袋面罩组治疗 24、48 h后的PaO2 高于本组治疗前,且高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);氧袋面罩组治疗 24、48 h后的OI高于氧气面罩组及鼻氧管组同时点,差异具有统计学意义(P<0.05);三组患者治疗 24、48 h后的SpO2 均高于本组治疗前,差异具有统计学意义(P<0.05).氧袋面罩组患者的OI<300 mm Hg 持续时间为(8.32±3.82)d、治疗有效率为 70.7%、气管插管率为 19.5%;氧气面罩组患者的OI<300 mm Hg 持续时间为(9.34±4.36)d、治疗有效率为 67.5%、气管插管率为 22.5%;鼻氧管组患者的OI<300 mm Hg 持续时间为(12.35±4.64)d、治疗有效率为 56.3%、气管插管率为 31.3%.氧袋面罩组及氧气面罩组患者的OI<300 mm Hg 持续时间均短于鼻氧管组,差异具有统计学意义(P<0.05);氧袋面罩组及氧气面罩组患者的OI<300 mm Hg 持续时间对比,差异无统计学意义(P>0.05);三组患者的治疗有效率及气管插管率两两对比,差异无统计学意义(P>0.05).结论 氧气面罩、氧袋面罩吸氧氧疗应用于重型病毒性肺炎患者较鼻氧管吸氧氧疗可更明显改善患者的血气指标,具有较高的安全性.
Study on clinical effect of three oxygen inhalation methods in the treatment of patients with severe viral pneumonia
Objective To discuss the clinical effect of nasal oxygen tube,oxygen mask,oxygen bag mask in the treatment of patients with severe viral pneumonia.Methods A total of 113 patients with severe viral pneumonia were studied,of which 32 cases received oxygen therapy by nasal oxygen tube(nasal oxygen tube group),40 cases received oxygen therapy by oxygen bag mask(oxygen bag mask group),and 41 cases received oxygen therapy by oxygen bag mask(oxygen bag mask group).Comparison was made on results of blood gas analysis[pH,arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),oxygenation index(OI),and oxygen saturation(SpO2)]before and after oxygen therapy,the duration of OI<300 mm Hg(1 mm Hg=0.133 kPa),treatment effective rate,and the rate of tracheal intubation among the three groups.Results Before treatment,there was no statistically significant difference in pH,PaO2,PaCO2,OI and SpO2 among the three groups(P>0.05).The pH value of the oxygen bag mask group after 48 h of treatment was higher than that before treatment in this group,and the difference was statistically significant(P<0.05).PaO2 of the oxygen bag mask group after 24 and 48 h of treatment was higher than that before treatment in this group,and higher than that of the oxygen mask group and nasal oxygen tube group at the same time point,and the difference was statistically significant(P<0.05).OI of the oxygen bag mask group after 24 and 48 h of treatment was higher than that of the oxygen mask group and nasal oxygen tube group at the same time point,and the difference was statistically significant(P<0.05).SpO2 of the three groups after 24 and 48 h of treatment was higher than that before treatment in this group,and the difference was statistically significant(P<0.05).The duration of OI<300 mm Hg in the oxygen bag mask group was(8.32±3.82)d,the treatment effective rate was 70.7％,the tracheal intubation rate was 19.5％;the duration of OI<300 mm Hg in the oxygen mask group was(9.34±4.36)d,the treatment effective rate was 67.5％,the tracheal intubation rate was 22.5％;the duration of OI<300 mm Hg in the nasal oxygen tube group was(12.35±4.64)d,the treatment effective rate was 56.3％,the tracheal intubation rate was 31.3％.The duration of OI<300 mm Hg in oxygen bag mask group and oxygen mask group was shorter than that in nasal oxygen tube group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the duration of OI<300 mm Hg between oxygen bag mask group and oxygen mask group(P>0.05).There was no statistically significant difference in treatment effective rate and tracheal intubation rate between every two of the three groups(P>0.05).Conclusion The application of oxygen mask and oxygen bag mask in patients with severe viral pneumonia can significantly improve their blood gas indicators,and has high safety compared to nasal oxygen tube oxygen therapy.
Severe viral pneumoniaNasal oxygen tubeOxygen maskOxygen bag maskOxygen therapyBlood gas analysisClinical outcome
NETL
NSTL
万方数据
维普
