经鼻高流量鼻导管湿化氧疗治疗中老年重症难治性肺炎合并呼吸衰竭的临床观察  

Clinical observation of nasal high-flow nasal canal humidification oxygen therapy for middle-aged and elderly patients with severe refractory pneumonia complicated with respiratory failure

作　　者：付会文[1] 赵智东 郭安[1] 林怀印 孙涛[1] FU Huiwen;ZHAO Zhidong;GUO An;LIN Huaiyin;SUN Tao(Department of Respiratory and Gastroenterology,Hengshui Second People's Hospital,Hebei Province,Hengshui 053000,China)

机构地区：[1]河北省衡水市第二人民医院呼吸消化科,053000

出　　处：《疑难病杂志》2019年第2期136-139,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省衡水市科技局项目(2017014040Z)

摘　　要：目的观察经鼻高流量鼻导管湿化氧疗治疗中老年重症难治性肺炎合并呼吸衰竭患者疗效及其对氧饱和度及预后的影响。方法 2016年4月-2018年4月河北省衡水市第二人民医院呼吸消化科诊疗重症难治性肺炎合并呼吸衰竭患者240例,随机数字表法分成2组,每组120例。对照组给予抗炎、平喘以及化痰等常规治疗联合经鼻正压通气吸氧治疗,观察组在常规治疗基础上给予经鼻高流量鼻导管湿化氧疗治疗。观察比较2组患者紫绀、气短以及肺部啰音等症状消失时间、生活质量及呼吸困难情况,以及动脉血气分析、氧饱和度改善及炎性因子变化。结果治疗后,观察组肺部啰音消失时间、气短消失时间、紫绀消失时间、SGRQ评分、Borg评分、IL-1、TNF-α、CRP水平、PaO_2、SaO_2、PaCO_2均优于对照组,差异均有统计学意义(t/P=10. 077/0. 000、12. 532/0. 000、17. 553/0. 000、14.483/0.000 15. 458/0. 000、21. 289/0. 000、19. 999/0. 000、24. 498/0. 000、16. 872/0. 000、8. 401/0. 000、7. 264/0.000)。结论采用经鼻高流量鼻导管湿化氧疗,能够改善重症难治性肺炎合并呼吸衰竭患者呼吸困难,促进疾病相关临床症状恢复,可以有效控制病情发展,改善患者预后。Objective To observe the effect of nasal high-flow nasal catheter humidification oxygen therapy on the treatment of elderly patients with severe refractory pneumonia complicated with respiratory failure and its effect on oxygen saturation and prognosis. Methods From April 2016 to April 2018,240 patients with severe refractory pneumonia complicated with respiratory failure were treated by the Department of Respiratory and Gastroenterology,Second People's Hospital of Hengshui City, Hebei Province. The random number table method was divided into two groups,120 cases in each group. The control group was given conventional treatments such as anti-inflammatory,antiasthmatic and phlegm combined with nasal positive pressure ventilation. The observation group was given a high-flow nasal catheter humidification oxygen therapy on the basis of conventional treatment. The disappearance time,quality of life and dyspnea of symptoms such as purpura,shortness of breath and lung vocalization were observed in the two groups. Arterial blood gas analysis,oxygen saturation improvement and inflammatory factors were observed. Results After treatment,the disappearance time of lung voice,disappearance time of air shortness,disappearance time of purpura,SGRQ score,Borg score,IL-1,TNF-α,CRP level,PaO2,SaO2,PaCO2 were better than those of the control group. Significance ( t/P =10.077/0.000, t/P =12.532/0.000, t/P =17.553/0.000, t/P =14.483/0.000, t/P = 15.458/ 0.000 , t/P =21.289/0.000, t/P =19.999/0.000, t/P =24.498/0.000, t/P =16.872/0.000, t/P =8.401/ 0.000 , t/P = 7.264 /0.000). Conclusion The use of nasal high-flow nasal catheter humidification oxygen therapy can improve the dyspnea of patients with severe refractory pneumonia complicated with respiratory failure,promote the recovery of disease-related clinical symptoms,and effectively control the development of the disease and improve the prognosis of patients.

关 键 词：鼻导管 氧疗 重症难治性肺炎 呼吸衰竭 

分 类 号：R563.1[医药卫生—呼吸系统]