经鼻高流量湿化氧疗在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭中的应用  

Application of Nasal High-flow Humidified Oxygen Therapy in Chronic Obstructive Pulmonary Disease with TypeⅡRespiratory Failure

作　　者：叶晓艺[1] 沈冰寒[1] 陈冬冬 陈晓芳 蔡志明[1] 黄颂平[1] YE Xiao-yi;SHEN Bing-han;CHEN Dong-dong;CHEN Xiao-fang;CAI Zhi-ming;HUANG Song-ping(Department of Respiratory and Critical Care Medicine,First Hospital of Quanzhou,Quanzhou,Fujian Province,362000 China)

机构地区：[1]福建省泉州市第一医院呼吸与危重症医学科,福建泉州362000

出　　处：《中外医疗》2020年第36期51-54,73,共5页China & Foreign Medical Treatment

基　　金：泉州市科技计划项目(2017Z037)。

摘　　要：目的研究经鼻高流量湿化氧疗(HFNC)治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法方便选取2018年1—12月期间在该院呼吸科住院的72例慢性阻塞性肺病合并Ⅱ型呼吸衰竭患者作为研究对象,随机分为试验组和对照组,36例对照组予经鼻导管低流量给氧,另外36例试验组予HFNC治疗,观察两组患者在治疗前后的生理指标以及治疗转归情况。结果两组的各生理指标在治疗前比较差异无统计学意义(P>0.05)。试验组在治疗后2 h、2 d,氧分压(PaO_(2))、pH值、氧饱和度(SpO2)二氧化碳分压(PaCO_(2))、心率(HR)、呼吸频率(RR)、氧合指数的改善较对照组明显,差异有统计学意义(P<0.05)。试验组在治疗后2 d,PaCO2的改善较对照组明显[(41.18±7.24)mmHg vs(55.28±2.38)mmHg],差异有统计学意义(P<0.05)。转归方面,试验组的插管率低于对照组(2.8%vs 22.2%),差异有统计学意义(χ^(2)=4.571,P=0.033),住院时间较对照组短[(19±11)d vs(28±12)d],差异有统计学意义(t=2.406,P=0.017)。两组患者的病死率(2.8%vs 8.3%),差异无统计学意义(P>0.05)。结论经鼻高流量湿化氧疗(HFNC)可以改善慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者的氧合指数等生理指标,也可降低插管率,缩短住院时间,但未能影响患者的病死率。Objective To study the clinical efficacy of nasal high-flow humidification oxygen therapy(HFNC)in the treatment of chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure.Methods 72 patients with chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure who were hospitalized in the respiratory department of the hospital from January to December 2018 were included as research subjects,and they were randomly divided into experimental group and control group.36 cases of control group received low-flow oxygen was given via a nasal catheter.The other 36 cases in the experimental group were treated with HFNC.The physiological indicators of the two groups of patients before and after treatment and the outcome of treatment were observed.Results There was no statistically significant difference between the two groups of physiological indicators before treatment(P>0.05).The improvement of oxygen partial pressure(PaO_(2)),pH value,oxygen saturation(SpO_(2)),Carbon dioxide partial pressure(PaCO_(2))heart rate(HR),respiratory rate(RR)and oxygenation index in the experimental group at 2 h and 2 d after treatment was more significant than that in the control group,the difference was statistically significant(P<0.05).The improvement of PaCO2 in the experimental group was more obvious than that in the control group at 2 d after treatment[(41.18±7.24)mmHg vs(55.28±2.38)mmHg],the difference was statistically significant(P<0.05).In terms of outcome,the intubation rate of the experimental group was lower than that of the control group(2.8%vs 22.2%),the difference was statistically significant(χ^(2)=4.571,P=0.033),and the hospital stay was shorter than that of the control group[(19±11)d vs(28±12)d],the difference was statistically significant(t=2.406,P=0.017).There was no statistically significant difference in mortality between the two groups(2.8%vs 8.3%)(P>0.05).Conclusion Transnasal high-flow humidification oxygen therapy(HFNC)can improve the oxygenation index and other physiological

关 键 词：经鼻高流量湿化氧疗 慢性阻塞性肺疾病 呼吸衰竭 

分 类 号：R4[医药卫生—临床医学]