山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (5): 31-36.doi: 10.6040/j.issn.1673-3770.0.2023.113

• 论著 • 上一篇    

高流量呼吸湿化治疗仪在喉癌术后人工气道非机械通气患者中的应用效果研究

刘萍,顾子君,储婷,陈曦,程雷   

  1. 南京医科大学第一附属医院/江苏省人民医院 耳鼻咽喉科, 江苏 南京 210029
  • 发布日期:2024-09-25
  • 通讯作者: 程雷. E-mail:jspent@126.com

Effect of high flow respiratory humidification therapy apparatus in patients with artificial airway without mechanical ventilation after laryngeal cancer surgery

LIU Ping, GU Zijun, CHU Ting, CHEN Xi, CHENG Lei   

  1. Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Published:2024-09-25

摘要: 目的 探讨高流量呼吸湿化治疗仪在喉癌术后人工气道非机械通气患者中的应用效果。 方法 随机选取行喉癌手术并在术后使用人工气道非机械通气的患者95例作为研究对象,对照组采用文丘里加温湿化氧疗装置进行气道湿化,观察组采用高流量呼吸湿化治疗仪高流量加温湿化,比较两组干预效果。 结果 95例中对照组53例、观察组42例,干预后两组患者的总住院天数、术后住院天数、每日吸痰次数、每日平均睡眠时间、每日憋气次数、湿化舒适度总分、疼痛改善情况等差异均具有统计学意义(P均<0.05)。 结论 对喉癌术后人工气道非机械通气患者使用高流量呼吸湿化治疗仪高流量加温湿化可改善患者气道湿化舒适度,促进痰液排出,缩短其总住院天数,改善患者预后。

关键词: 喉癌, 高流量呼吸湿化治疗仪, 文丘里加温湿化氧疗装置, 人工气道非机械通气

Abstract: Objective To explore the application effect of high flow respiratory humidification therapy instrument in patients with artificial airway after laryngeal cancer surgery without mechanical ventilation. Methods Objective sampling method was used to randomly select patients who underwent laryngeal cancer surgery and underwent artificial airway with non-mechanical ventilation after surgery as study objects. The control group underwent airway humidification using Venturi's humidifying oxygen therapy device. The experimental group was treated with high flow respiratory humidification therapy apparatus with high flow temperature humidification, and the intervention effect of the two groups was compared. Results A total of 95 patients were included, including 53 patients in the control group and 42 patients in the observation group. There were statistically significant differences in the total number of days in hospital, postoperative hospital stay, number of sputum aspiration per day, average sleep time per day, number of breath-holding per day, total score of humidification comfort and pain between the two groups after intervention(all P<0.05). Conclusion For patients with artificial airway after laryngeal cancer surgery without mechanical ventilation, the use of high flow respiratory humidification therapy apparatus with high flow temperature humidification can improve the comfort of airway humidification, promote sputum discharge, shorten the total length of hospital stay and improve the prognosis of patients with laryngeal cancer.

Key words: Laryngeal carcinoma, High flow respiratory humidification therapy instrument, Venturi's humidifying oxygen therapy device, Non-mechanical ventilation artificial airway

中图分类号: 

  • R473.76
[1] 申宇鹏, 宋琦, 李晓明. 喉癌前病变的病因、分子机制和处理策略[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 25-30. doi: 10.6040 /j.Issn.1673-3770.1.2019.029 SHEN Yupeng, SONG Qi, LI Xiaoming. Etiology, molecular mechanisms, and treatment strategies of precancerous laryngeal lesions[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 25-30. doi: 10.6040 /j.Issn.1673-3770.1.2019.029
[2] Hans S, Baudouin R, Circiu MP, et al. Laryngeal cancer surgery: history and current indications of transoral laser microsurgery and transoral robotic surgery[J]. J Clin Med, 2022, 11(19): 5769. doi:10.3390/jcm11195769
[3] Gong H, Wu J, Sun J, et al. Preoperative tracheotomy in the treatment of upper airway obstruction of patients with advanced stage supraglottic carcinoma[J]. Am J Otolaryngol, 2022, 43(3): 103381. doi:10.1016/j.amjoto.2022.103381
[4] Botti C, Menichetti M, Marchese C, et al. The role of tracheotomy in patients with moderate to severe impairment of the lower airways[J]. Acta Otorhinolaryngol Ital, 2022, 42(suppl. 1): S73-S78. doi:10.14639/0392-100x-suppl.1-42-2022-08
[5] 石玉琦, 佘翠平, 张庆丰, 等. 早期声门型喉癌低温等离子射频术后喉部感染诊治经验与教训[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 129-134. doi:10.6040/j.issn.1673-3770.0.2021.163 SHI Yuqi, SHE Cuiping, ZHANG Qingfeng, et al. Experience and lessons of diagnosis and treatment of laryngeal infection after low temperature plasma ra-diofrequency surgery for early glottic carcinoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 129-134. doi:10.6040/j.issn.1673-3770.0.2021.163
[6] 李利杰, 田秀芬. CO2激光联合低温等离子治疗早期声门型喉癌40例[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 79-85, 96. doi:10.6040/j.issn.1673-3770.0.2021.188 LI Lijie, TIAN Xiufen. Forty cases of early glottic cancer treated by CO2 laser surgery combined with radiofrequency ablation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 79-85, 96. doi:10.6040/j.issn.1673-3770.0.2021.188
[7] 张赞华, 金盈盈, 黄晨梦. 高流量呼吸湿化治疗仪在程序化撤机中的应用[J]. 中国现代医学杂志, 2021, 31(3): 76-79. doi:10.3969/j.issn.1005-8982.2021.03.014
[8] 魏立峰, 杨私, 李雨桐, 等. 高流量呼吸湿化治疗仪的机理分析与数据建模[J]. 计算机测量与控制, 2020, 28(6): 257-260, 265. doi: 10.16526/j.cnki.11-4762/tp.2020.06.052 WEI Lifeng, YANG Si, LI Yutong, et al. Mechanism analysis and data modeling of high-flow heated respiratory humidifier[J]. Computer Measurement & Control, 2020, 28(6): 257-260, 265. doi: 10.16526/j.cnki.11-4762/tp.2020.06.052
[9] Ospina-Tascón GA, Calderón-Tapia LE, García AF, et al. Effect of high-flow oxygen therapy vs conventional oxygen therapy on invasive mechanical ventilation and clinical recovery in patients with severe COVID-19: a randomized clinical trial[J]. JAMA, 2021, 326(21): 2161-2171. doi:10.1001/jama.2021.20714
[10] 左红霞, 柯玉芳, 张超, 等. 高流量呼吸湿化治疗仪对我国人工气道患者临床疗效的Meta分析[J]. 湖北医药学院学报, 2021, 40(2): 139-148. doi:10.13819/j.issn.2096-708X.2021.02.007 ZUO Hongxia, KE Yufang, ZHANG Chao, et al. The clinical efficacy of high flow respiratory humidification therapeutic apparatus on patients with artificial airway in China: a meta-analysis[J]. Journal of Hubei University of Medicine, 2021, 40(2): 139-148. doi:10.13819/j.issn.2096-708X.2021.02.007
[11] Brustia R, Monsel A, Skurzak S, et al. Guidelines for perioperative care for liver transplantation: enhanced recovery after surgery(ERAS)recommendations[J]. Transplantation, 2022, 106(3): 552-561. doi:10.1097/TP.0000000000003808
[12] Romanelli E, Tankéré F, Vaillant JC, et al. Re: surgical tracheotomy[J]. J Visc Surg, 2022, 159(2): 181-182. doi:10.1016/j.jviscsurg.2021.11.002
[13] Klee K, Wilfond B, Thomas K, et al. Conflicts between parents and clinicians: Tracheotomy decisions and clinical bioethics consultation[J]. Nurs Ethics, 2022, 29(3): 685-695. doi:10.1177/09697330211023986
[14] 杨顺银, 陈进参, 高原, 等. T管联合文丘里加温湿化氧疗在气管切开脱机病人中的应用[J]. 蚌埠医学院学报, 2021, 46(9): 1300-1303. doi: 10.13898/j.cnki.issn.1000-2200.2021.09.039 YANG Shunyin, CHEN Jincan, GAO Yuan, et al. Application value of T-tube combined with Venturi warm humidifying oxygen therapy in patients with tracheotomy offline[J]. Journal of Bengbu Medical College, 2021, 46(9): 1300-1303. doi: 10.13898/j.cnki.issn.1000-2200.2021.09.039
[15] Mandal M, Bhattacharya D, Mukherjee P, et al. High-flow versus venturi mask oxygen therapy to prevent reintubation: a matter of time or device?[J]. Am J Respir Crit Care Med, 2023, 207(6): 798. doi:10.1164/rccm.202211-2113le
[16] Cheng Z, Geng XK, Tong YN, et al. Adjuvant high-flow normobaric oxygen after mechanical thrombectomy for anterior circulation stroke: a randomized clinical trial[J]. Neurotherapeutics, 2021, 18(2): 1188-1197. doi:10.1007/s13311-020-00979-3
[17] 张创良, 张勇, 陈元椿, 等. AIRVO2与传统正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者内皮素-1、肿瘤坏死因子-α与血浆中性粒细胞明胶酶相关载脂蛋白水平影响[J]. 临床军医杂志, 2020, 48(6)729-730. doi: 10.16680/j.1671-3826.2020.06.36 ZHANG Chuangliang, ZHANG Yong, CHEN Yuanchun, et al. Effects of AIRVO2 _ 2 and traditional positive pressure ventilation on endothelin-1, tumor necrosis factor-α and plasma neutrophil gelatinase-related apolipoprotein levels in patients with obstructive sleep apnea hypopnea syndrome[J]. Clinical Journal of Medical Officers, 2020, 48(6)729-730. doi: 10.16680/j.1671-3826.2020.06.36
[18] Hui D, Hernandez F, Urbauer D, et al. High-flow oxygen and high-flow air for dyspnea in hospitalized patients with cancer: a pilot crossover randomized clinical trial[J]. Oncologist, 2021, 26(5): e883-e892. doi:10.1002/onco.13622
[19] Pelaez CA, Jackson JA, Hamilton MY, et al. High flow nasal cannula outside the ICU provides optimal care and maximizes hospital resources for patients with multiple rib fractures[J]. Injury, 2022, 53(9): 2967-2973. doi:10.1016/j.injury.2022.05.017
[20] 高雅, 周晓静, 金妍. 高流量呼吸湿化治疗仪治疗老年低氧型呼吸衰竭的疗效及对患者血气及C反应蛋白、降钙素原水平的影响[J]. 实用医院临床杂志, 2022, 19(2): 130-133. doi: 10.3969/j.issn.1672-6170.2022.02.036 GAO Ya, ZHOU Xiaojing, JIN Yan. The efficacy of high-flow respiratory humidification therapeutic apparatus in the treatment of elderly patients with hypoxic respiratory failure and its influence on blood gas and levels of C-reactive protein and procalcitonin[J]. Practical Journal of Clinical Medicine, 2022, 19(2): 130-133. doi: 10.3969/j.issn.1672-6170.2022.02.036
[21] 李娜, 周淋琳, 黄群. 高流量呼吸湿化氧疗在胸外科术后患者中的疗效观察[J]. 国际护理学杂志, 2023, 42(3): 435-439. doi: 10.3760/cma.j.cn221370-20210712-00107 LI Na, ZHOU Linlin, HUANG Qun. Efficacy of high-flow respiratory humidified oxygen therapy in postoperative thoracic surgery patients[J]. International Journal of Nursing, 2023, 42(3): 435-439.doi: 10.3760/cma.j.cn221370-20210712-00107
[22] 霍霞, 宋水, 王业. 不同设定指标高流量呼吸湿化治疗仪对气管切开患者干预效果观察[J]. 人民军医, 2021, 64(4): 339-342. doi:10.3969/j.issn.1000-9736.2021.04.016 HUO Xia, SONG Shui, WANG Ye. Observation on intervention effect of high-flow respiratory humidification therapeutic instrument with different setting indexes on tracheotomy patients[J]. People's Military Surgeon, 2021, 64(4): 339-342. doi:10.3969/j.issn.1000-9736.2021.04.016
[23] 葛永会, 程林, 刘杰. 持续雾化吸入法在喉癌气管切开术后患者中的应用[J]. 齐鲁护理杂志, 2021, 27(14): 147-149. doi: 10.3969/j.issn.1006-7256.2021.14.058 GE Yonghui, CHENG Lin, LIU Jie. Application of continuous atomizing inhalation in patients with laryngeal carcinoma after tracheotomy[J]. Journal of Qilu Nursing, 2021, 27(14): 147-149.doi: 10.3969/j.issn.1006-7256.2021.14.058
[24] Thomas M, Joshi R, Cave G. How much PEEP does high flow deliver via tracheostomy? A literature review and benchtop experiment[J]. Crit Care Res Pract, 2021, 2021: 6036891. doi:10.1155/2021/6036891
[25] 蔡毅峰,李杨,苏素刁, 等.呼吸湿化治疗仪对气管插管患者机体应激及脱机安全性的影响[J]. 广东医学, 2018, 39(5): 733-736. doi:10.13820/j.cnki.gdyx.2018.05.009
[26] Anon. High flow oxygen therapy[J]. Arch Dis Child, 2023, 108(3): 177. doi: 10.1136/archdischild-2023-325437
[27] Maggiore SM, Jaber S, Grieco DL, et al. High-flow versus VenturiMask oxygen therapy to prevent reintubation in hypoxemic patients after extubation: a multicenter randomized clinical trial[J]. Am J Respir Crit Care Med, 2022, 206(12): 1452-1462. doi:10.1164/rccm.202201-0065oc
[28] Jung D, Gusti V, Vaghadia H. Novel application of AIRVOTM 2 for the management of postoperative hypoxemia due to severe laryngeal stenosis[J]. J Clin Anesth, 2020, 65: 109872. doi:10.1016/j.jclinane.2020.109872
[29] Wyatt KD, Goel NN, Whittle JS. Recent advances in the use of high flow nasal oxygen therapies[J]. Front Med(Lausanne). 2022, 9: 1017965. doi:10.3389/fmed.2022.1017965
[30] Wen R, Hu X, Wei T, et al. High-flow nasal cannula: evaluation of the perceptions of various performance aspects among Chinese clinical staff and establishment of a multidimensional clinical evaluation system[J]. Front Med(Lausanne), 2022, 9: 900958. doi:10.3389/fmed.2022.900958
[1] 王靖淞,余灿,张西,邓启成,谢卓良,赵锐,温蓓,刘海. KRT4在喉癌及癌旁正常黏膜组织中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 12-17.
[2] 张竹萍,叶琪,郭蓓,林凌. 叶酸受体阳性循环肿瘤细胞检测在喉鳞状细胞癌诊断中的应用价值[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 50-53.
[3] 张西,邓启成,张震,程瑶,王靖淞,赵锐,刘海. 营养支持对喉癌术后咽瘘影响的Meta分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 51-59.
[4] 徐翀,王晓亭,易红良. 单细胞测序分析喉癌及其微环境代谢相关靶基因[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 33-38.
[5] 黄恒丰,马鲲鹏,杨迪,张丽君,张盛林. miR-181b-5P和EPB41L3蛋白在喉癌中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 41-46.
[6] 李利杰,田秀芬. CO2激光联合低温等离子治疗早期声门型喉癌40例[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 79-85.
[7] 王媚 李志海. 喉癌干细胞:克服多药耐药性的潜在治疗靶点[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 120-128.
[8] 王晓亭,陈正侬,易红良. 利用RNA-seq探讨谷氨酰胺剥夺对喉癌细胞转录组的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 26-31.
[9] 冯成敏,敬一丹,刘海,王冰. 咽喉部鳞状细胞癌细胞系[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 113-124.
[10] 李艳杰, 贾建,杨萍,万保罗. 肿瘤异常蛋白在喉癌临床诊断中的价值研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 70-74.
[11] 陈国平,傅敏仪,叶飞,徐建慧. 早期声门型喉癌钬激光与CO2激光手术对比研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 8-11.
[12] 吴允刚,张辉,孙聚兴,刘涛,王彩华,杨欣欣,马林祥,李笑颖,庞太忠,李晓瑜. 环甲膜联合喉室入路切除T1B声门型喉癌临床疗效分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 30-34.
[13] 石玉琦,佘翠平,张庆丰,刘得龙,焦梦思. 早期声门型喉癌低温等离子射频术后喉部感染诊治经验与教训[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 129-134.
[14] 周恩,肖禹,肖旭平. 等离子射频消融技术在早期声门型喉癌治疗中的应用进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 9-15.
[15] 肖旭平,周恩,肖禹. 等离子点状激发射频消融技术治疗早期声门型喉癌(Tis-T1b)31例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 60-66.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!