急性闌尾炎術後使用高流量鼻導管氧氣治療降低術後再插管－個案報告

Reduced Reintubation with High-flow Nasal Cannula Oxygen Therapy after Acute Appendicitis: A Case Report

紀亞禎(Ya-Chen Chi) ； 張少維(Shao-Wei Chang) ； 賴怡文(Yi-Wen Lai) ； 馮瑞芳(Jui-Fang Feng) ； 曾妮(Ni Tseng)

《北市醫學雜誌》 預刊文章 Pp. 1-6

https://doi.org/10.6200/TCMJ.202307/PP.0024

摘要

急性闌尾炎是常見的腹部外科急症，根據統計全世界約有6∼7%的人都經歷過闌尾炎。本篇為急性闌尾炎合併腹膜炎術後插管使用呼吸器的病人，訓練脫離呼吸器時，因腹脹導致腹內壓增加，在測量呼吸器脫離指標時，病人過程中呈現呼吸淺快、蹺蹺板式呼吸型態、血氧飽和濃度下降，因此在拔管後立即使用高流量鼻導管氧氣治療（high flow nasal cannula oxygen therapy, HFNC）以避免再插管的發生，後續個案呼吸型態改善，更換氧氣鼻導管使用，如期出院，藉由個案分享其呼吸照護經驗。

關鍵字

急性闌尾炎 ； 腹脹 ； 高流量鼻導管 ； 避免再插管

並列摘要

Acute appendicitis is a common abdominal surgical emergency. About 6 to 7% of people around the world have had experienced appendicitis according to the statistics. This article describes a patient who was intubated and used a respirator after acute appendicitis complicated with peritonitis. The patient's intra-abdominal pressure increased because of abdominal distension during ventilator weaning training. When measuring the index of respirator detachment, the patient showed shallow breathing and a seesaw breathing pattern; the blood oxygen saturation concentration decreased, and thus the High Flow Nasal Cannula Oxygen Therapy (HFNC) was used immediately after extubation to avoid reintubation. Subsequently, the patient's breathing pattern improved, and the oxygen nasal cannula was replaced. The patient was discharged as scheduled. We share the respiratory care experiences through this case study.

並列關鍵字

acute appendicitis ； abdominal distension ； high-flow nasal cannula ； avoidance of reintubation