| 李涵,贺伟忠,刘姝昕,岳修勤.高流量氧疗联合深镇静拔管对老年高血压患者苏醒质量的影响[J].浙江中西医结合杂志,2025,35(11): |
| 高流量氧疗联合深镇静拔管对老年高血压患者苏醒质量的影响 |
| Effects of high-flow nasal cannula oxygen therapy combined with deep sedation and extubation on the quality of resuscitation in elderly patients with hypertension |
| 投稿时间：2025-02-10 修订日期：2025-06-05 |
| DOI： |
| 中文关键词: 老年 高血压 全身麻醉 深镇静拔管 经鼻高流量氧疗 |
| 英文关键词:Elderly Hypertension General anesthesia Deep sedation tube drawing High-flow nasal cannula oxygen therapy |
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| 中文摘要: |
| 目的：探讨高流量氧疗（HFNC）联合深镇静拔管对老年高血压患者苏醒质量的影响。方法：选取本院择期行下腹部手术的全麻气管插管老年高血压患者177例。将患者随机分为H组（深镇静拔管+HFNC）、C组（深镇静拔管+面罩给氧）、N组（清醒拔管+面罩给氧）3组，每组59例，观察并比较各组患者的苏醒期情况舒适度、湿润度、不良反应及拔管后平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2)、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）的变化。结果：C组和H组患者的MAP、HR、RR、SpO2、PaCO2、拔管时间、Ricker镇静-躁动评分、呛咳、低氧血症、恶心呕吐发生率及湿润度评分明显低于N组（P<0.05），PaO2明显高于N组（P<0.05）；H组的MAP、HR、RR、PaCO2及Ricker镇静-躁动评分低于C组（P<0.05），PaO2及舒适度评分高于N组（P<0.05）。结论：老年高血压全麻手术患者在PACU深镇静下拔管后应用HFNC，可以改善患者血流动力学和氧合状态，有利于促进患者早期康复。 |
| 英文摘要: |
| Objective: To investigate the effect of HFNC combined with deep sedation and extubation on the recovery quality of elderly patients with hypertension. Methods: A total of 177 elderly hypertensive patients with tracheal intubation under general anesthesia for lower abdominal operation in our hospital were selected. The patients were randomly divided into the H group (deep sedation extubation +HFNC), the C group (deep sedation extubation + mask oxygen), and the N group (awake extubation + mask oxygen), with 59 cases in each group. The comfort, wetness, adverse reactions and the changes of mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), SpO2, PaO2, PaCO2 after extubation were observed and compared in each group. Results: MAP, HR, RR, SpO2, PaCO2, extubation time, Ricker sedation-agitation score, incidence of bucking, hypoxemia, nausea and vomiting, and wetness score in C and H groups were significantly lower than those in N group (P<0.05), and PaO2 was significantly higher than that in N group (P<0.05). The H group demonstrated lower values in MAP, HR, RR, PaCO2 and Ricker sedation-agitation scores in compared to the C group (P<0.05). Conversely, the H group showed higher values in and PaO2 and comfort scores when compared to the N group (P<0.05). Conclusions: The application of HFNC in elderly patients with hypertension after extubation under deep sedation in PACU can improve the hemodynamics and oxygenation status of patients, and promote the early recovery of patients. |
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