摘要
目的探索研究经鼻高流量湿化氧疗(HFNC)及鼻导管氧疗(NCO)应用于慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者的治疗效果。方法选取2018年3月至2021年3月安徽省滁州市第一人民医院呼吸科收治的80例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象,以随机数字表法将患者均分为观察组和对照组,每组各40例。观察组在基础治疗上增加HFNC治疗,对照组在基础治疗上增加NCO治疗。两组患者总治疗时间均≥3 d。比较两组患者治疗前后心率、呼吸频率、平均动脉压;比较两组患者治疗前后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))及氧合指数(PaO_(2)/FiO_(2)),并于患者出院时进行治疗舒适度调查。结果治疗3 d后,两组患者心率、呼吸频率和平均动脉压均较治疗前显著下降,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗3 d后,两组患者PaO_(2)和PaO_(2)/FiO_(2)水平均较本组治疗前显著升高,PaCO_(2)较本组治疗前显著降低,差异有统计学意义(P<0.05);治疗前及治疗3 d后两组患者PaO_(2)、PaCO_(2)和PaO_(2)/FiO_(2)水平比较,差异无统计学意义(P>0.05)。两组患者治疗舒适度比较,差异有高度统计学意义(P<0.01)。结论HFNC及NCO对于AECOPD合并Ⅱ型呼吸衰竭患者均有着较为稳定的疗效,但HFNC相较于NCO有着更好的治疗缓解率和治疗舒适度,临床实践中可针对氧疗需求患者广泛开展HFNC治疗。
Objective To explore the therapeutic effect of transnasal high-flow nasal cannula oxygen therapy(HFNC)and nasal catheter oxygen therapy(NCO)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with type Ⅱ respiratory failure.Methods A total of 80 patients with AECOPD complicated with type Ⅱ respiratory failure admitted to Department of Respiratory,the First People’s Hospital of Chuzhou of Anhui Province from March 2018 to March 2021 were selected as the research objects.The patients were divided into observation group and control group by random number table method,with 40 cases in each group.HFNC was added to the basic treatment in the observation group,and NCO was added to basic treatment in the control group.The total treatment time of two groups was more than or equal to three days.The heart rate,respiratory rate and mean arterial pressure of the two groups before and after treatment were compared.Arterial partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),and partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen(PaO_(2)/FiO_(2))of the two groups before and after treatment were compared.The comfort level of treatment was investigated at discharge.Results After three days of treatment,heart rate,respiratory rate and mean arterial pressure in two groups were significantly decreased compared with before treatment,and observation group was lower than control group,the differences were statistically significant(P<0.05).After three days of treatment,the levels of PaO_(2) and PaO_(2)/FiO_(2) in two groups were significantly increased compared with before treatment,and PaCO_(2) was significantly decreased compared with before treatment,the differences were statistically significant(P<0.05).There were no significant differences in PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2) levels between two groups before and after three days of treatment(P>0.05).Comparison of treatment comfort between the two groups showed highly statistically significant difference(P<0.01).Conclusion HFNC and NCO both have relatively stable efficacy for patients with AECOPD combined with type Ⅱ respiratory failure,but HFNC has a better remission rate and treatment comfort compared with NCO.HFNC can be widely used for patients requiring oxygen therapy in clinical practice.
作者
张艳喜
尚龙梅
芮晓艳
ZHANG Yanxi;SHANG Longmei;RUI Xiaoyan(Department of Respiratory,the First People’s Hospital of Chuzhou,Anhui Province,Chuzhou 239000,China)
出处
《中国医药导报》
CAS
2022年第7期112-115,共4页
China Medical Herald
关键词
慢性阻塞性肺疾病急性加重期
Ⅱ型呼吸衰竭
经鼻高流量湿化氧疗
鼻导管氧疗
疗效
Acute exacerbation of chronic obstructive pulmonary disease
Type Ⅱ respiratory failure
High-flow nasal cannula oxygen therapy
Nasal catheter oxygen therapy
Curative effect
作者简介
通讯作者:芮晓艳。
