经鼻高流量吸氧治疗慢阻肺急性加重期合并Ⅱ型呼吸衰竭的临床研究  

Therapeutic effects of high flow oxygen inhalation through nose in treatment of acute exacerbation of chronic obstructive pulmonary disease complicated by typeⅡrespiratory failure

作　　者：柴书坤[1] 史金英[1] 李艳肖[1] 王震[1] 王小琳[1] CHAI Shukun;SHI Jinying;LI Yanxiao(The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院,050011

出　　处：《河北医药》2020年第24期3768-3771,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划(编号:161460783)。

摘　　要：目的探讨经鼻高流量吸氧在慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭治疗中的应用效果。方法选取2017年4月至2018年4月入住的慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者40例,依据随机数字表法,分为试验组和对照组,每组20例。试验组给予常规治疗,并接受经鼻高流量吸氧;对照组给予文丘里面罩装置控制性氧疗。比较2组患者血气指标、RR、患者舒适度、护理操作难易程度等情况。结果治疗24 h结束后,比较4 h及24 h 2组指标,试验组末梢血氧饱和度(SpO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血pH值、呼吸频率(RR)等指标均优于对照组(P<0.01),患者舒适度高于对照组(P<0.01),护理操作难度低于对照组(P<0.01)。结论经鼻高流量吸氧在改善慢性阻塞性肺疾病急性加重患者治疗效果方面优于控制性氧疗,能有效提升患者舒适度,降低护理人员操作难度,此治疗方法具有推广意义。Objective To investigate the therapeutic effects of high flow oxygen inhalation through nose in treatment of acute exacerbation of chronic obstructive pulmonary disease complicated by typeⅡrespiratory failure.Methods A total of 40 patients with chronic obstructive pulmonary disease complicated by typeⅡrespiratory failure who were admitted and treated in our hospital from April 2017 to April 2018 were enrolled in the study,who were divided into experimental group(n=20)and control group(n=20)according to random number table.The patients in experimental group were treated by conventional therapy combined with high flow oxygen inhalation through nose,however the patients in control group were treated by controlled oxygen therapy through Venturi mask device.After treatment,the blood gas indexes,RR,comfort degree of patients and the complexity of nursing operation were observed and compared between the two groups.Results After 24-hour treatment,the indexes of oxyhemoglobin’saturation of peripheral blood(SpO2),arterial partial pressure of oxygen(PaO2),partial pressure of carbon dioxide in artery(PaCO2),the pH value of arterial blood,respiratory rate(RR)in experimental group were superior to those in control group(P<0.01).Moreover the comfort degree of patients in experimental group was significantly higher than that in control group(P<0.01),and the nursing procedure difficulty in experimental group was significantly lower than that in control group(P<0.01).Conclusion The high flow oxygen inhalation through nose is superior to controlled oxygen therapy in improving the therapeutic effects on acute exacerbation of chronic obstructive pulmonary disease,which can effectively improve the comfort degree of patients and reduce the nursing procedure difficulty,thus,which is worthy of promotion in clinical practice.

关 键 词：呼吸衰竭 经鼻高流量吸氧 慢性阻塞性肺疾病 面罩吸氧 

分 类 号：R563[医药卫生—呼吸系统]