经鼻高流量湿化氧疗在重症肺部感染合并呼吸衰竭患者脱机后的应用OA

Objective:To investigate the application of high-flow nasal canula(HFNC)in patients with severe pulmonary infection complicated with respiratory failure after weaning.Method:A total of 90 patients with severe pulmonary infection complicated with respiratory failure admitted to Ganzhou Hospital of Guangdong Provincial People's Hospital(Ganzhou Municipal Hospital)from September 2022 to May 2023 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 45 cases in each group.All patients met the weaning criteria.The control group was given conventional oxygen therapy after weaning,and the observation group was given HFNC after weaning.The success rate of weaning and the rate of re-intubation after successful weaning 24,48,96 h and 1 week and the levels of Th1 and Th2 cytokines[tumor necrosis factor-α(TNF-α)and interleukin(IL)-6]in serum were compared between the two groups.Blood gas analysis[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation(SaO2)]of the two groups at 12 and 24 h after weaning were observed,and the incidence of hypoxemia within 24 h of oxygen therapy and complications within 1 week of oxygen therapy in the two groups were analyzed.Result:PaO2 and SaO2 levels in observation group were higher than those in control group at 12 and 24 h after weaning,and PaCO2 level at 24 h after weaning was lower than that in control group(P<0.05).There was no significant difference in weaning success rate between the two groups(P>0.05).There was no significant difference in the rate of re-intubation between the two groups after 24 h successful weaning(P>0.05).The re-intubation rates of the observation group 48,96 h and 1 week after successful weaning were significantly lower than those of the control group(P<0.05).The incidences of hypoxemia within 24 h oxygen therapy and other complications within 1 week of oxygen therapy in observation group were lower than those in control group(P<0.05).After treatment,the levels of TNF-α and IL-6 were decreased in both groups,and those in the observation group were lower than those in the control group(P<0.05).Conclusion:HFNC can effectively improve blood gas indexes in patients with severe pulmonary infection complicated with respiratory failure after weaning,effectively regulate Th1,Th2 cytokines,reduce pulmonary inflammation,improve respiratory function,increase the success rate of weaning,and reduce the incidence of complications and re-intubation rate.