经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期合并轻中度Ⅱ型呼吸衰竭患者的临床效果  

Clinical Effect of High-Flow Nasal Cannula Oxygen Therapy on Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with TypeⅡMild-to-Moderate Respiratory Failure

作　　者：向茜 邓超[1] 张强敏 颜文凯 Xiang Qian;Deng Chao;Zhang Qiangmin;Yan Wenkai(Department of Respiratory and Critical Care Medicine,Zhongjiang People's Hospital,Deyang Sichuan 618100,China;Southern Medical University,Guangzhou Guangdong 510000,China)

机构地区：[1]中江县人民医院呼吸与危重症医学科,四川德阳618100 [2]南方医科大学,广东广州510000

出　　处：《医疗装备》2023年第3期67-69,73,共4页Medical Equipment

摘　　要：目的探讨经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并轻中度Ⅱ型呼吸衰竭患者的临床效果。方法选取2020年11月至2021年10月于中江县人民医院治疗的AECOPD合并轻中度Ⅱ型呼吸衰竭患者40例作为研究对象,随机分为两组,每组20例。对照组行无创正压机械通气治疗,试验组行经鼻高流量氧疗,比较两组治疗前和治疗2、24、72 h后的动脉血气指标[包括pH、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))],以及住院时间和治疗有效率。结果治疗前和治疗2、24、72 h后,两组动脉血气指标比较,差异均无统计学意义(P>0.05);两组组内不同时间点动脉血气指标比较,差异有统计学意义(P<0.05)。试验组住院时间长于对照组,差异有统计学意义(P<0.05);两组治疗有效率比较,差异无统计学意义(P>0.05)。结论经鼻高流量氧疗有助于改善AECOPD合并轻中度Ⅱ型呼吸衰竭患者的动脉血气指标,其有效性与无创机械正压通气相当,不增加治疗失败风险,且具有患者耐受度好、医护操作简便的优势。Objective The clinical effect of high-flow nasal cannula oxygen therapy on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡmild-to-moderate respiratory failure was investigated.Methods With selection of 40patients with AECOPD complicated with typeⅡmild-to-moderate respiratory failure who were treated in Zhongjiang People’s Hospital from November 2020 to October 2021 as the study subjects randomly divided into two groups,with 20 patients in each group,the control group received non-invasive positive pressure mechanical ventilation therapy,and the experimental group received high-flow nasal cannula oxygen therapy.The arterial blood gas indexes,including pH,arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2)),before treatment and at the time of 2,24 and 72 hours after treatment,as well as the length of hospital stay and the effective rate of treatment were compared between the two groups.Results There was no significant difference in arterial blood gas indexes between the two groups before treatment and at 2,24 and 72 hours after treatment(P>0.05);The arterial blood gas indexes at different time points in the two groups were significantly different(P<0.05).The hospitalization time of the experimental group was longer than that of the control group,and the difference was statistically significant(P<0.05);There was no statistically significant difference between the two groups in treatment effectiveness(P>0.05).Conclusion With the advantages of good patient tolerance and simple medical and nursing operation,high-flow nasal cannula oxygen therapy can help improve the arterial blood gas index of AECOPD patients complicated with typeⅡmild-to-moderate respiratory failure.In addition,its effectiveness is no-inferior to that of non-invasive positive pressure mechanical ventilation,and it does not increase the failure rate.

关 键 词：经鼻高流量氧疗 无创正压机械通气 慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 动脉血气 

分 类 号：R563[医药卫生—呼吸系统]