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中华重症医学电子杂志 ›› 2019, Vol. 05 ›› Issue (02) : 203 -206. doi: 10.3877/cma.j.issn.2096-1537.2019.02.022

所属专题: 重症营养 经典病例 文献

病例报告

高流量鼻导管氧疗治疗食道癌术后呼吸衰竭一例
潘纯1, 许媛2, 杨毅1,()   
  1. 1. 210009 南京,东南大学附属中大医院重症医学科
    2. 102218 北京,清华大学附属北京清华长庚医院重症医学科
  • 收稿日期:2017-09-19 出版日期:2019-05-28
  • 通信作者: 杨毅
  • 基金资助:
    国家自然科学基金(81300043); 江苏省医学重点学科(实验室)(ZDXKA2016025); 江苏省医学重点人才(ZDRCA2016082)

High-flow nasal cannula oxygen therapy for respiratory failure in a post-esophagectomy patient: A case report

Chun Pan1, Yuan Xu2, Yi Yang1,()   

  1. 1. Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
    2. Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, Beijing 102218, China
  • Received:2017-09-19 Published:2019-05-28
  • Corresponding author: Yi Yang
  • About author:
    Corresponding author: Yang Yi, Email:
引用本文:

潘纯, 许媛, 杨毅. 高流量鼻导管氧疗治疗食道癌术后呼吸衰竭一例[J]. 中华重症医学电子杂志, 2019, 05(02): 203-206.

Chun Pan, Yuan Xu, Yi Yang. High-flow nasal cannula oxygen therapy for respiratory failure in a post-esophagectomy patient: A case report[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(02): 203-206.

急性呼吸衰竭是食道癌术后常见的并发症,食道癌术后患者由于术中肺萎陷、重力依赖区肺泡塌陷、肺微血管内皮细胞损伤、胸腔胃、痰液黏稠及术后疼痛等原因会导致通气及换气功能障碍。无创机械通气往往是这一类患者的相对禁忌。随着经鼻高流量氧疗技术的不断进步,其无创、减少口鼻咽部解剖死腔、呼气末正压通气(PEEP)效应、增加呼气末肺容积、气道湿化和改善舒适度等优点被广泛认识,其能够改善食道癌术后患者的氧合,避免再次插管。本文就经鼻高流量对1例食道癌术后患者呼吸衰竭的治疗进行介绍。

Acute respiratory failure is a common complication after radical resection of esophageal carcinoma. Dependent area alveolar collapse in and after surgery, pulmonary microvascular endothelial injury, intrathoracic stomach, sticky sputum and postoperation pain could lead to ventilational dysfunction. Noninvasive ventilation is relatively contraindicted for patients with these medical situations. High-flow nasal cannula oxygen therapy has a number of medical benefits: reduction of anatomical dead space, PEEP effects, increase in end-expiratory lung volume, improved comfort. High-flow nasal cannula oxygen can improve oxygenation of post-esophagectomy patients and avoid reintubation. This paper introduces the effects of high-flow nasal cannula oxygen therapy on respiratory failure in a post-esophagectomy patient.

图1 患者入住重症医学科术后胸部正位片
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