经鼻高流量湿化氧疗治疗ACPE的疗效及对患者血气分析指标的影响  

Clinical efficacy of nasal high-flow humidification oxygen therapy in the treatment of acute cardiogenic pulmonary edema and its influence on blood gas analysis indexes

作　　者：张帅 刘满仙 刘健斌 ZHANG Shuai;LIU Man-xian;LIU Jian-bin(Department of Respiratory and Critical Care Medicine,the Fourth People's Hospital of Foshan,Foshan 528000,Guangdong,CHINA)

机构地区：[1]佛山市第四人民医院呼吸与危重症医学科,广东佛山528000

出　　处：《海南医学》2022年第1期90-92,共3页Hainan Medical Journal

摘　　要：目的探讨经鼻高流量湿化氧疗治疗急性心源性肺水肿(ACPE)的疗效及对患者血气分析指标的影响。方法选择2019年1月至2020年11月佛山市第四人民医院呼吸与危重症医学科收治的50例ACPE患者为研究对象,根据随机数表法将患者分为研究组27例和对照组23例,两组患者均采用对症治疗,对照组在对症治疗基础上,给予普通鼻导管吸氧治疗,研究组在对症治疗基础上,给予经鼻高流量湿化氧疗治疗。治疗24 h后,比较两组患者的治疗效果、临床症状(心率、肺水肿消失时间、肺部啰音消失时间)、血气分析指标[动脉血二氧化碳分压(PaCO_(2))、酸碱度(pH)、血氧饱和度(SaO_(2))]水平。结果治疗后,研究组患者的治疗总有效率为92.59%,明显高于对照组的65.22%,差异有统计学意义(P<0.05);治疗后,研究组患者的心率、肺水肿消失时间、肺部啰音消失时间分别为(83.01±4.37)次/min、(25.76±5.23)h、(29.01±5.73)h,明显低(短)于对照组的(105.36±5.23)次/min、(69.02±10.30)h、(75.39±8.46)h,差异均有统计学意义(P<0.05);治疗后,研究组患者的PaCO_(2)为(24.08±6.21)mmHg,明显低于对照组的(32.87±7.30)mmHg,pH、SaO_(2)水平分别为7.38±0.06、(89.23±9.34)%,明显高于对照组的7.32±0.12、(83.05±8.31)%,差异均有统计学意义(P<0.05)。结论经鼻高流量湿化氧疗可有效缓解ACPE患者的临床症状及体征,改善血气指标,提高治疗效果,临床应用价值高。Objective To study the clinical efficacy of nasal high flow humidification oxygen therapy in the treatment of acute cardiogenic pulmonary edema(ACPE)and its influence on blood gas analysis indexes.Methods Fifty patients with ACPE who received treatment in Department of Respiratory and Critical Care Medicine,the Fourth People's Hospital of Foshan from January 2019 to January 2020 were selected for this study.According to the method of drawing lots,they were divided into a study group(n=27)and a control group(n=23).On the basis of symptomatic treatment,the control group was given oxygen inhalation through common nasal catheter,and the study group was treated with nasal high-flow humidification oxygen therapy.After 24 hours of treatment,the treatment effect,clinical symptoms(heart rate,disappearance time of pulmonary edema,disappearance time of pulmonary rales)and blood gas analysis indexes(PaCO_(2),pH,SaO_(2))were compared between the two groups.Results After treatment,the total effective rate of study group was 92.59%,significantly higher than 65.21%in the control group(P<0.05).After treatment,the heart rate,the disappearance time of pulmonary edema,and the disappearance time of pulmonary rales in the study group were(83.01±4.37)times/min,(25.76±5.23)h,(29.01±5.73)h,significantly lower(shorter)than(105.36±5.23)times/min,(69.02±10.30)h,(75.39±8.46)h in the control group(P<0.05).After treatment,PaCO_(2)of the study group were(24.08±6.21)mmHg,significantly lower than(32.87±7.30)mmHg in the control group(P<0.05).pH,SaO_(2)level were 7.38±0.06,(89.23±9.34)%,significantly higher than 7.32±0.12,(83.05±8.31)%in the control group(P<0.05).Conclusion Nasal high-flow oxygen humidification therapy can effectively relieve the clinical symptoms and signs of patients with ACPE,improve blood gas index,and improve the therapeutic effect.

关 键 词：急性心源性肺水肿 经鼻高流量湿化氧疗 疗效 血气分析指标 并发症 

分 类 号：R563.2[医药卫生—呼吸系统]