早期高流量鼻氧对隔膜功能和胸部手术后肺部并发症的影响:一项随机临床试验
Alberto Fogagnolo1, Salvatore Grasso2, Martin Dres3
1Emergency Department, Section of Anaesthesia and Intensive Care, Azienda Ospedaliera-Universitaria Sant' Anna, Ferrara, Italy.
Journal of clinical anesthesia
|July 24, 2025
概括
高流量鼻 (HFNC) 氧气治疗没有减少胸部手术后的术后并发症或腹膜功能障碍. 然而,HFNC可能会减轻患有隔膜功能障碍的患者的风险.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 关键的护理关键的护理
背景情况:
- 手术后的肺部并发症 (PPC) 在胸部手术后很常见.
- 隔膜功能障碍是PPC的重要危险因素.
- 高流量鼻 (HFNC) 氧气治疗可能会减少呼吸工作和正极呼吸压力 (PEEP).
研究的目的:
- 调查HFNC在减少PPC和胸腔外科手术后腹膜功能障碍方面的疗效.
- 评估HFNC对患有或没有隔膜功能障碍的患者的影响.
主要方法:
- 一个单中心,开放标签,随机对照试验,涉及116名接受视频辅助胸腔镜叶切除术的患者.
- 患者被随机分配到接受常规氧气治疗 (COT) 或HFNC.
- 测量了隔膜位移和加厚分数,并在7天内记录了PPC.
主要成果:
- 两组之间隔膜功能障碍率 (29%的HFNC与36%的COT) 或PPC (55%的HFNC与64%的COT) 没有显著差异.
- 与COT (81%) 相比,腹膜功能障碍患者在HFNC (54%) 中显示出较少的PPC (51%).
- 后期分析表明,HFNC在患有隔膜功能障碍的患者中降低了PPC风险 (OR 0.16).
结论:
- 早期的HFNC支持并没有降低术后隔膜功能障碍或呼吸道并发症的总体发生率.
- HFNC可能有助于减轻PPC风险,特别是在患有术后隔膜功能障碍的患者中.
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