| 王大鹏,聂晓伟,潘 红,许红阳,陈静瑜.经鼻高流量湿化氧疗治疗肺移植术后移植物失功患者的临床研究[J].,2017,17(34):6709-6712 |
| 经鼻高流量湿化氧疗治疗肺移植术后移植物失功患者的临床研究 |
| A Clinical Study on Humidified High Flow Nasal Cannula Therapy for Patients with Primary Graft Dysfunction after Lung Transplantation |
| 投稿时间：2017-06-16 修订日期：2017-06-30 |
| DOI：10.13241/j.cnki.pmb.2017.34.023 |
| 中文关键词: 经鼻高流量湿化氧疗 肺移植 严重移植物失功 |
| 英文关键词: Humidified high flow nasal cannula Lung transplantation Primary graft dysfunction |
| 基金项目:国家自然科学基金青年基金项目（81500039） |
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| 中文摘要: |
| 摘要 目的：探讨经鼻高流量湿化氧疗系统(Humidified High Flow Nasal Cannula，HFNC)治疗肺移植术后原发性移植物失功的治疗效果。方法：选取2015年1月1日至 2016年12月31日在我院行肺移植手术后出现原发性移植物的患者48例，并将其随机分为两组，分别应用 HFNC 或 NPPV 进行治疗，比较两组患者不同时间点(入组当时、入组后24、48、72小时)的氧合指数PaO2/FiO2、再插管率、气管切开率、呼吸机相关性肺炎(VAP)的发生率、病死率及ICU住院时间。结果：入组后24、48、72小时，HFNC组氧合指数 PaO2/FiO2 均明显高于NPPV 组(P<0.05)，再次插管率、气管切开率、VAP发生率均显著低于NPPV组(P<0.05)。患者ICU住院时间较NPPV组明显缩短(P<0.05)， 住院病死率显著低于NPPV组，但两组差异无统计学意义(P>0.05)。结论：在掌握应用指征的前提下，HFNC治疗肺移植术后移植物失功患者可有效改善其氧合和预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the therapeutic effect of Humidified High Flow Nasal Cannula (HFNC) on the primary graft failure after lung transplantation. Methods: Forty-eight patients with primary grafts who underwent lung transplantation from January 1, 2015 to December 31, 2016 were randomly divided into two groups: HFNC or NPPV (P <0.05). The oxygenation index PaO2/FiO2, re-intubation rate, tracheotomy rate, ventilator-associated pneumonia (VAP) were compared between the two groups at different time points (at 24, 48, 72 hours after admission), the mortality and ICU hospital stay were also compared. Results: The PaO2/FiO2 of HFNC group was significantly higher than that of the NPPV group at 24, 48 and 72 hours after admission (P<0.05), and the rate of intubation, tracheotomy rate and VAP were significantly lower than NPPV Group (P<0.05). The hospitalization time of ICU was significantly shorter than that of the NPPV group (P<0.05). The hospital mortality was significantly lower than that of NPPV group, but there was no significant difference between the two groups (P>0.05). Conclusion: HFNC can effectively improve the oxygenation and prognosis of patients with graft failure after lung transplantation under the premise of mastery of application indications. |
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