经鼻高流量加温湿化吸氧治疗对慢性阻塞性肺疾病合并肺源性心脏病的临床效果  

Clinical study on treatment of chronic obstructive pulmonary disease with pulmonary heart disease by nasal high-flow warming humidification and oxygen therapy

作　　者：赵智东 付会文[1] 崔利锋[1] 郭安[1] 林怀印 孙涛[1] 孙文豹[1] ZHAO Zhidong;FU Huiwen;CUI Lifeng;GUO An;LIN Huaiyin;SUN Tao;SUN Wenbao(Department of Respiratory and Gastroenterology,the Second People′s Hospital of Hengshui,Hengshui,Hebei 053000,China)

机构地区：[1]河北省衡水市第二人民医院呼吸消化科

出　　处：《检验医学与临床》2019年第14期1989-1992,1996,共5页Laboratory Medicine and Clinic

基　　金：河北省衡水市科技局项目(2017014040Z)

摘　　要：目的探讨经鼻高流量加温湿化吸氧治疗对慢性阻塞性肺疾病(COPD)合并肺源性心脏病(简称肺心病)的临床效果。方法选择2017-2018年在该院呼吸消化科进行治疗的240例COPD合并肺心病患者作为研究对象,按照随机数字表法将患者分为对照组与观察组,每组各120例,对照组患者给予常规治疗,观察组患者在对照组患者治疗的基础上给予经鼻高流量加温湿化吸氧治疗,对两组患者治疗前后的肺功能指标,动脉血气指标及治疗效果进行比较。结果经过治疗后,两组患者的第1秒用力呼气容积、第1秒用力呼气量与用力肺活量率、第1秒用力呼气量与用力肺活量比值、动脉血氧分压、动脉血二氧化碳分压、血氧饱和度、血清C反应蛋白(CRP)和N-末端脑钠肽前体(NT-proBNP)参数均出现了改善,观察组患者改善的幅度大于对照组患者,组间比较差异均有统计学意义(t=-4.720、-7.059、-6.281、-14.992、12.065、-7.527、4.824、 10.451 , P<0.05),观察组患者的治疗效果优于对照组患者,差异有统计学意义(Z=-7.328, P<0.05)。结论对 COPD合并肺心病患者给予经鼻高流量加温湿化吸氧治疗,可以明显改善患者的肺功能与动脉血气指标,明显降低患者血清CRP和NT-proBNP水平,具有较好的临床应用价值。Objective To investigate the clinical effect of transnasal high-flow warming humidification and oxygen therapy on chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease.Methods A total of 240 patients with COPD and pulmonary heart disease who were treated in the Department of Respiratory and Digestive Diseases of the Second People′s Hospital of Hengshui from 2017 to 2018 were selected as objects,and divided into control group and observation group according to a random number method,and 120 patients in each group.The patients in the control group were given conventional treatment,and the patients in the observation group were given a high-dose warming and humidified oxygen therapy on the basis of the treatment of the control group,and the pulmonary function index,arterial blood gas index and effects of the treatment were compared.Results After treatment,the data of FEV1,FEV1%,FEV1/FVC,arterial oxygen partial pressure,arterial blood pressure,oxygen saturation,serum C reactive protein (CRP) and N-terminal natriuretic peptide precursor (NT-proBNP) improved in patients of two groups.The improvements of the patients in the observation group were greater than those of the control group,and the differences were statistically significant (t=-4.720,-7.059,-6.281,-14.992,12.065,-7.527,4.824,10.451,P<0.05).The treatment effect of the observation group was better than that of the control group,and the difference was statistically significant (Z=-7.328,P<0.05).Conclusion The treatment of patients with COPD complicated with pulmonary heart disease by nasal high-flow warming humidification oxygen therapy can significantly improve the lung function and arterial blood index of patients,significantly reduce the serum CRP and NT-proBNP concentration,and has good clinical application value.

关 键 词：慢性阻塞性肺疾病 肺源性心脏病 C反应蛋白 N-末端脑钠肽前体 

分 类 号：R563.3[医药卫生—呼吸系统]