经鼻高流量鼻导管湿化氧疗治疗老年重症肺炎合并呼吸衰竭的疗效评价  

Efficacy evaluation of nasal high-flow nasal cannula humidification oxygen therapy in the treatment of senile severe pneumonia complicated with respiratory failure

作　　者：徐秋燕[1] 劳永光[1] 吴兴达 XU Qiuyan;LAO Yongguang;WU Xingda(Surgical Intensive Care Unit,Zhanjiang Central People's Hospital,Guangdong,Zhanjiang 524000,China;Guangdong Medical University,Guangdong,Zhanjiang 524000,China)

机构地区：[1]广东省湛江中心人民医院外科重症监护室,广东湛江524000 [2]广东医科大学,广东湛江524000

出　　处：《中国医药科学》2020年第12期194-196,226,共4页China Medicine And Pharmacy

摘　　要：目的探讨老年重症肺炎合并呼吸衰竭患者应用经鼻高流量鼻导管湿化氧疗的临床效果。方法选取我院2017年1月~2019年1月收治的80例老年重症肺炎合并呼吸衰竭患者进行研究,随机分为对照组(n=40)与研究组(n=40)。两组患者均给予抗炎、化痰、平喘等常规治疗,在此基础上,对照组给予经鼻正压吸氧治疗,研究组给予经鼻高流量鼻导管湿化氧疗,比较两组临床疗效、症状消失时间、炎症指标及血气指标水平。结果研究组临床总有效率为95.00%,高于对照组(80.00%),差异有统计学意义(P<0.05)。在气促消失时间、肺部啰音消失时间、发绀消失时间、三凹征消失时间方面,研究组短于对照组,差异有统计学意义(P<0.05)。在血白细胞、C反应蛋白(CRP)、降钙素原(PCT)水平方面,研究组水平低于对照组,差异有统计学意义(P<0.05)。研究组二氧化碳分压(PaCO2)低于对照组,血氧分压(PaO2)、血氧饱和度(SaO2)高于对照组,差异有统计学意义(P<0.05)。结论老年重症肺炎合并呼吸衰竭患者应用经鼻高流量鼻导管湿化氧疗后,可显著改善患者临床症状,减轻炎症反应,临床应用效果十分显著。Objective To investigate and analyze the clinical effect of nasal high-flow nasal cannula humidification oxygen therapy in the treatment of senile severe pneumonia complicated with respiratory failure.Methods 80 patients with severe pneumonia complicated with respiratory failure admitted to our hospital from January 2017 to January 2019 were enrolled in this study.The patients were randomly divided into control group(n=40)and study group(n=40).Patients in both groups were given conventional treatments,such as anti-inflammatory,phlegm reduction and asthma.On the basis of this,the control group was given nasal positive pressure oxygen therapy,and the study group was given nasal high-flow nasal cannula humidification oxygen therapy.The clinical efficacy,time to symptom disappearance,inflammation indicators and blood gas index were compared between the two groups.Results The total effective rate of the study group was 95.00%,which was higher than that of the control group(80.00%),and the difference was statistically significant(P<0.05).The time to disappearance of shortness of breath,lung rales,cyanosis and the three-concave sign in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The levels of white blood cells,C-reactive protein(CRP)and procalcitonin(PCT)in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The carbon dioxide partial pressure(PaCO2)of the study group was lower than that of the control group,and the blood oxygen partial pressure(PaO2)and blood oxygen saturation(SaO2)were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The use of nasal high-flow nasal cannula humidification oxygen therapy in patients with senile severe pneumonia complicated with respiratory failure can significantly improve clinical symptoms and reduce inflammatory response of patients,with extremely significant clinical application effects.

关 键 词：重症肺炎 呼吸衰竭 经鼻高流量鼻导管湿化氧疗 炎症反应 

分 类 号：R563[医药卫生—呼吸系统]