不同湿度经鼻高流量吸氧对AECOPD合并呼吸衰竭患者治疗效果对比  

Therapeutic Effects of High-Flow Nasal Cannula Oxygen Therapy Through Nose with Different Humidity on AECOPD Patients with Respiratory Failure

作　　者：王波[1] 董琼[1] 蒋莉[1] 蒲青 Wang Bo;Dong Qiong;Jiang Li(Department of Respiratory Medicine,Nanchong Central Hospital,Second Clinical Medical College of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院第二临床医学院·南充市中心医院呼吸内科,四川南充637000

出　　处：《四川医学》2021年第1期48-53,共6页Sichuan Medical Journal

摘　　要：目的对比不同湿度经鼻高流量吸氧(HFNC)对慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者治疗效果。方法选择2018年6月至2019年12月在我院接受治疗的AECOPD合并呼吸衰竭患者96例,采用随机数字表法将患者分为三组,各32例。所有患者均在常规治疗基础上给与HFNC治疗,三组温度均控制在31℃~37℃,相对湿度A组控制在<60%,B组61%~80%,C组81%~100%。比较三组患者临床疗效、呼吸功能、血气分析指标、吸氧舒适度及依从性。结果B组总有效率93.75%,高于A组71.88%及C组68.75%,差异有统计学意义(P<0.05)。治疗前三组mMRC评分及CAT评分差异无统计学意义(P>0.05),治疗后三组患者mMRC评分及CAT评分均低于治疗前,且B组mMRC评分及CAT评分均低于A组及C组,差异有统计学意义(P<0.05)。治疗前三组患者pH、氧分压及二氧化碳分压差异无统计学意义(P>0.05),治疗后三组pH及氧分压均明显升高,但B组治疗后pH及氧分压均高于A组与C组,治疗后三组二氧化碳分压均明显下降,但B组治疗后二氧化碳分压低于A组与C组,差异有统计学意义(P<0.05)。B组舒适度评分及总依从率均高于A组及C组(P<0.05),A组与C组比较差异无统计学意义(P>0.05)。结论当温度在31℃~37℃时,HFNC相对湿度控制在61%~80%可提高AECOPD合并呼吸衰竭患者疗效,改善患者呼吸功能、血气分析指标,并可提高吸氧舒适度及依从性。Objective To compare therapeutic effects of high-flow nasal cannula oxygen therapy(HFNC)with different humidity on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.Methods From June 2018 to December 2019,96 AECOPD patients with respiratory failure who were treated in our hospital were selected.All patients were divided into 3 groups with 32 cases in each group by random number table method.On the basis of conventional and HFNC treatment,temperature of three groups was controlled at 31℃~37℃.For relative humidity,group A was controlled at<60%,group B was 61%~80%,and group C was 81%~100%.Clinical efficacy,respiratory function,blood gas analysis indexes,oxygen inhalation comfort and compliance were compared.Results Total effective rate in group B was 93.75%,which was higher than 71.88%in group A and 68.75%in group C with statistically significant difference(P<0.05).Before treatment,there were no significant differences in mMRC and CAT among three groups(P>0.05).After treatment,mMRC and CAT were lower than before treatment,and mMRC and CAT of group B were lower than those of group A and C with statistically significant difference(P<0.05).There were no significant difference in pH,oxygen partial pressure(PaO_(2))and carbon dioxide partial pressure(PaCO_(2))in three groups before treatment(P>0.05).After treatment,pH and PaO_(2) in three groups were significantly increased.Moreover,pH and PaO_(2) in group B were increased than group A and C after treatment.After treatment,PaCO_(2) in three groups decreased significantly.Moreover,PaCO_(2) in group B was lower than that of group A and C with statistically significant difference(P<0.05).Comfort score and total compliance rate of group B were higher than those of group A and C(P<0.05).There was no significant difference between group A and C(P>0.05).Conclusion For AECOPD patients with respiratory failure,when temperature is 31~37℃,HFNC relative humidity controlled at 61%~80%could improve curative effect by improvi

关 键 词：湿度 经鼻高流量吸氧 慢性阻塞性肺疾病急性加重期 呼吸衰竭 

分 类 号：R563[医药卫生—呼吸系统]