高流量湿化氧疗对老年脑梗死卧床患者肺部感染的疗效分析

摘要

目的 探讨高流量湿化氧疗对老年脑梗死卧床患者肺部感染的临床疗效.方法 回顾性选取2015年5月 ~2017年1月在承德医学院附属医院老年病科住院的老年脑梗死卧床肺部感染患者70例,根据给氧方法不同分为对照组和试验组.对照组患者采用传统鼻导管、吸氧面罩方式给氧,试验组患者采用新型高流量呼吸湿化氧疗系统给氧.观察两组患者治疗1、4和24 h后心率、呼吸频率、血压、血气指标变化,患者咳痰能力改变,以及发生院内感染率、耐药菌的发生率、抗生素使用时间.结果 两组患者治疗前后血压水平比较,差异无统计学意义(P>0.05).两组患者治疗1、4和24 h后心率、呼吸次数、血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)、pH值及氧和指数水平均较治疗前改善,试验组患者治疗后心率、呼吸频率、PaO2、PaCO2、SaO2及氧和指数均优于同时间点对照组(P<0.05).两组患者治疗后痰液黏稠度分级情况均较治疗前改善,试验组患者治疗后痰液黏稠度优于对照组(P<0.05).试验组患者院内感染率、耐药菌发生率均低于对照组,抗生素使用时间短于对照组(P<0.05).结论 高流量湿化氧疗可改善老年脑梗死卧床患者肺部感染的血气指标和呼吸功能,提高患者舒适度,降低院内感染率和耐药菌发生率.%Objective To analyze the effect of high flow humidification oxygen therapy on pulmonary infection in elderly patients with cerebral infarction and the effect on oxygen saturation and pneumonia in patients with cerebral infarction. Methods A retrospective study was conducted on 70 elderly patients with pulmonary infarction who were hospitalized in geriatrics department of Affiliated Hospital of Chengde Medical College from May 2015 to January 2017. The patients were divided into control group and experimental group according to different oxygen feeding methods.The control group was treated with traditional nasal catheter oxygen mask,the experimental group were treated with high respiratory flow humidified oxygen. The heart rate,respiratory frequency,blood pressure,blood gas index change,change the expectoration ability of patients,the hospital infection rate and patients,the incidence of drug-resistant bacteria,antibiotic use time were observed in the two groups. Results There was no difference of blood pressure before and after treatment in two groups(P> 0.05). 1H,4H two groups,24h heart rate,respiratory rate,PaO2,PaCO2,SaO2,PH and oxygen index levels were improved dramatically after treatment than before treatment in two groups(P< 0.05),and these treatment index were better in experimental group than in control group after treatment(P < 0.05). Two groups of patients after treatment of sputum viscosity grade was improved too after treatment in the two groups(P < 0.05),and the sputum characters was better in experimental group than control group after treatment(P< 0.05). The rate of internal infection and the incidence of drug-resistant bacteria in experimental group were lower than those of the control group,and the time of antibiotics use was shorter in experimental group than that in control group(P<0.05).Conclusion High flow humidification oxygen therapy can improve the blood gas index and respiratory function of pulmonary infection in elderly patients with bedridden cerebral infarction,and improve the comfort of patients,and reduce the incidence of nosocomial infection and the incidence of drug-resistant bacteria.