HFNC与NPPV对慢性阻塞性肺疾病Ⅰ型呼吸衰竭患者的疗效研究  

Therapeutic effect of HFNC and NPPV on patients with chronic obstructive pulmonary disease combined with type Ⅰ respiratory failure

作　　者：王慧敏[1] 戈改真[1] 孙建芳[1] WANG Huimin;GE Gaizhen;SUN Jianfang(Department of Respiratory Medicine,the First Affiliated Hospital of Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院第一附属医院呼吸科

出　　处：《中国现代医生》2019年第12期9-11,共3页China Modern Doctor

摘　　要：目的比较新型无创通气——经鼻高流量氧疗(high-flow nasal cannula,HFNC)与无创正压通气(noninvasive positive pressure ventilation,NPPV)两种无创通气模式在慢性阻塞性肺疾病Ⅰ型呼吸衰竭患者中的疗效。方法选取2016年1月~2017年12月两年间在包头医学院第一附属医院呼吸内科住院的慢性阻塞性肺疾病Ⅰ型呼吸衰竭的患者60例,随机分为HFNC组和NPPV组,支持参数根据患者进行设定,比较两种呼吸支持方法在开始治疗后的不同时间点对患者心率、血压、脉氧、血气分析、插管率等方面的差异。结果 HFNC组患者在心率、血压、脉氧、PaO2等方面的改善优于NPPV组(P<0.05),舒适度BCS评分HFNC组(3.8±0.4)明显优于NPPV组(2.1±0.8)(P<0.05)。两种通气模式在插管率方面无显著性差异。结论患者对HFNC的接受程度更高,耐受性更好,在提高氧分压、稳定生命体征、改善血流动力学方面有很好的效果,但在插管率方面,两种通气方式没有明显的差异。Objective To compare the efficacy between two noninvasive ventilation modes including high-flow nasal cannula(HFNC) and noninvasive positive pressure ventilation(NPPV) in patients with chronic obstructive pulmonary disease combied with type Ⅰ respiratory failure. Methods 60 patients with chronic obstructive pulmonary disease and type I respiratory failure admitted in the Department of Respiratory Medicine, First Affiliated Hospital of Baotou Medical College from January 2016 to December 2017 were randomly divided into HFNC group and NPPV group. Support parameters were set according to the patients settings. The differences in the effects of the two respiratory support methods on heart rate, blood pressure, pulse oxygen, blood gas analysis, and intubation rate at different time points after starting treatment were compared. Results The improvement of heart rate, blood pressure, pulse oxygen and PaO2 in the HFNC group was better than that in the NPPV group(P<0.05). The comfort BCS score(3.8±0.4) of HFNC was significantly better than(2.1±0.8) of NPPV(P<0.05). There was no significant difference in intubation rate between the two ventilation modes. Conclusion Patients have higher acceptance and better tolerance to HFNC, which has good effects in improving oxygen partial pressure, stabilizing vital signs and improving hemodynamics. However, in terms of intubation rate, there are no significant differences between two ventilation methods.

关 键 词：经鼻高流量氧疗 无创机械通气 慢性阻塞性肺疾病 Ⅰ型呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]