经鼻高流量氧疗和持续气道正压通气治疗重叠综合征患者的临床分析  

Clinical Analysis of High Flow Nasal Cannula and Continuous Positive Airway Pressure for Patients with Overlap Syndrome

作　　者：李特 周琼 贺新良 张卓然[2] LI Te;ZHOU Qiong;HE Xinliang;ZHANG Zhuoran(Union Hospital,Huazhong University of Science and Technology,Wuhan 430000,China;不详)

机构地区：[1]华中科技大学附属协和医院,湖北武汉430000 [2]湖北省黄石市第二医院

出　　处：《中国医学创新》2023年第5期1-5,共5页Medical Innovation of China

摘　　要：目的:研究经鼻高流量湿化氧疗(HFNC)和持续气道正压通气(CPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并慢阻肺(合称“重叠综合征”)的效果。方法:选取2019年9月-2021年9月黄石市第二医院收治的90例重叠综合征患者,随机分为观察组和对照组,每组45例,观察组给予HFNC治疗,对照组给予持续气道正压通气(CPAP)治疗,比较两组治疗前及治疗1个月后CAT评分、Epworth嗜睡量表(ESS)评分、第1秒用力呼气容积占预计值的百分比(FEV_(1)%pred)、C反应蛋白(CRP)、夜间最低血氧饱和度(SaO_(2))、睡眠呼吸暂停低通气指数(AHI)及呼吸机相关不良事件发生率。结果:治疗后,两组FEV_(1)%pred均高于治疗前,观察组FEV_(1)%pred高于对照组(P<0.05)。治疗后,两组夜间最低SaO_(2)均高于治疗前,观察组夜间最低SaO_(2)低于对照组(P<0.05)。治疗后,两组ESS评分、AHI均低于治疗前,观察组ESS评分、AHI均高于对照组(P<0.05)。治疗后,两组CAT评分、CRP均低于治疗前,观察组CAT评分、CRP均低于对照组(P<0.05)。观察组呼吸机相关不良事件发生率为2.22%,低于对照组的20.00%(P<0.05)。结论:HFNC及CPAP均是治疗重叠综合征患者的有效方法,CPAP可以改善患者睡眠呼吸相关指标,而HFNC能更好地改善患者慢阻肺症状,呼吸机相关不良事件发生率相对更低,对于不能耐受无创呼吸机治疗的患者,可以选择HFNC治疗。Objective:To investigate the efficacy of nasal high flow nasal cannula(HFNC)and continuous positive airway pressure(CPAP)in the treatment of OSAHS complicated with COPD(OSAHS-COPD overlap syndrome).Method:A total of 90 patients with OCOS admitted to the Second Hospital of Huangshi from September 2019 to September 2021 were selected,they were randomly divided into observation group and control group,45cases in each group.The observation group was treated with HFNC,and the control group was treated with CPAP.CAT score,Epworth sleepiness scale(ESS)score,FEV_(1)%pred,C reactive protein(CRP),nocturnal minimum oxygen saturation(SaO_(2)),sleep apnea-hypopnea index(AHI)before treatment and 1 month after treatment and incidence of ventilator-related adverse events were compared between the two groups.Result:After treatment,the FEV_(1)%pred of the two groups were higher than those before treament,and the FEV_(1)%pred of the observation group was higher than that of the control group(P<0.05).The lowest SaO_(2)in the two groups at night were higher than those before treament,and the SaO_(2)in the observation group after treatment was lower than that in the control group(P<0.05).The ESS scores and AHI of the two groups were lower than those before treament,the ESS score and AHI of the observation group after treatment were higher than those of the control group(P<0.05).The CAT scores and CRP of the two groups were lower than those before treament,the CAT score and CRP of the observation group after treatment were lower than those of the control group(P<0.05).The incidence of adverse reactions in the observation group was 2.22%,lower than 20.00%in the control group(P<0.05).Conclusion:Both HFNC and CPAP are effective methods for treating patients with overlap syndrome.CPAP can improve the indexes related to sleep breathing in such patients,while HFNC can better improve the symptoms of COPD in such patients,the incidence of ventilatorrelated adverse events is relatively lower,for patients who cannot tolerate non-invasive breathi

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 慢阻肺 重叠综合征 经鼻高流量湿化氧疗 持续气道正压通气 

分 类 号：R766[医药卫生—耳鼻咽喉科] R563.9[医药卫生—临床医学]