摘要
目的自制一种新型简易呼吸器,观察呼吸器对重型和危重型新型冠状病毒肺炎(新冠肺炎)患者的氧疗效果。方法基于新冠肺炎具有传染性的特殊性和院感的要求,南昌大学第二附属医院麻醉科的医护人员设计出一种新型简易呼吸器,并于2020年2月15日至3月15日援鄂期间用于华中科技大学同济医学院附属肿瘤中心收治的22例需要氧疗的重型和危重型新冠肺炎患者。新型简易呼吸器包含2项国家实用新型专利(一种呼吸器:ZL 201520410623.6,一种流体开关及吸氧装置:ZL 201720873509.6),主要由麻醉面罩、过滤器(人工鼻暂替)、L型连接管、软性呼吸囊、连接管和弹性固定带组成。使用时,用弹性固定带将麻醉面罩固定于患者口鼻处,将连接管插入氧表接口,调整氧流量为6~10 L/min,待软性呼吸囊充满后立即打开L型连接管上的排气口,排放体内二氧化碳和多余的氧气;调低氧流量至2~3 L/min,通过软性呼吸囊起伏观察患者的呼吸频率(RR),并随时调整氧流量。观察患者应用新型简易呼吸器前后脉搏血氧饱和度(SpO2)、RR和心率(HR)的变化,并收集部分患者的血气分析结果。结果22例重型和危重型新冠肺炎患者应用新型简易呼吸器10 min后SpO2即较应用前明显升高(0.994±0.007比0.952±0.017,P<0.01),RR即较应用前明显降低(次/min:27.59±3.63比29.64±3.81,P<0.01);应用1 d后,各指标进一步改善。接受血气分析的13例患者经血气分析均提示无二氧化碳蓄积现象。结论新型简易呼吸器可显著改善重型和危重型新冠肺炎患者的氧疗效果,同时可通过过滤器过滤2019新型冠状病毒(2019-nCoV),减少气溶胶的形成,保护医务人员和患者的安全。
Objective To make a new simple respirator and observe the oxygen therapy effect of the respirator on patients with severe and critical coronavirus disease 2019 (COVID-19).Methods Based on the infectivity and hospital requirements of COVID-19, a new simple respirator was designed by the medical staff of the Department of Anesthesiology of the Second Affiliated Hospital of Nanchang University, which was applied on the 22 patients with severe and critical COVID-19 who needed oxygen therapy admitted to the Cancer Center of Tongji Medical College of Huazhong University of Science and Technology from February 15th to March 15th in 2020. The new simple respirator contained two National Utility Model Patents (a respirator: ZL 2015 2 0410623.6, a fluid switch and oxygen suction device: ZL 2017 2 0873509.6), which was mainly composed of anesthesia mask and filter, L-shaped connecting tube, soft breathing bladder, connecting tube and elastic fixing belt. When in use, the anesthesia mask was fixed to the patient's mouth and nose with elastic straps, the connecting tube was inserted into the oxygen meter interface, the oxygen flow was adjusted to 6-10 L/min, and the L-shaped connecting tube was opened immediately after the soft breathing bag was full. The carbon dioxide and excess oxygen in the body was discharged from exhaust port. The oxygen flow was lowered to 2-3 L/min, the patient's respiratory rate (RR) was observed through the soft breathing bag fluctuations, and the oxygen flow was adjusted at any time. The changes of pulse oxygen saturation (SpO2), RR and heart rate (HR) before and after application of new simple respirator were observed, and the blood gas test results of part of the patients were collected.Results Twenty-two patients with severe and critical COVID-19 had significantly higher SpO2 at 10 minutes after application of the new simple ventilator than before application (0.994±0.007 vs. 0.952±0.017, P < 0.01), and RR was significantly lower than that before application (times/min: 27.59±3.63 vs. 29.64±3.81, P < 0.01);after 1 day of application, each index was further improved. All 13 patients who received blood gas analysis indicated no carbon dioxide accumulation.Conclusions The new simple respirator can significantly improve the oxygen therapy effect of patients with severe and critical COVID-19. At the same time, 2019 novel coronavirus (2019-nCoV) can be filtered through the filter to reduce the formation of aerosol and protect the medical staff and patients.
作者
华福洲
王羲凤
黄向飞
肖凡
魏根
应俊
郭莲
胡谦
何显炬
余树春
徐国海
徐建军
Hua Fuzhou;Wang Xifeng;Huang Xiangfei;Xiao Fan;Wei Gen;Ying Jun;Guo Lian;Hu Qian;He Xianju;Yu Shuchun;Xu Guohai;Xu Jianjun(Department of Anesthesiology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Gastroenterology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Emergency,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Outpatient,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;Department of Cardiothoracic Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2020年第7期864-868,共5页
Chinese Critical Care Medicine
基金
国家实用新型专利(ZL 201520410623.6,ZL 201720873509.6)
江西省基层卫生适宜技术"星火推广计划"项目(20188015)
江西省杰出青年人才项目(20192BCB23024)。
关键词
新型冠状病毒肺炎
氧疗
呼吸
新型简易呼吸器
Coronavirus disease 2019
Oxygen therapy
Respiration
New simple respirator
