探究HFNC、NPPV对慢阻肺高碳酸血症老年患者动脉血气变化的影响  

Effect of HFNC and NPPV on Arterial Blood Gas in Elderly Patients with Chronic Obstructive Pulmonary Hypercapnia

作　　者：柯剑辉 林艺坚 张国新 蔡鸿鸿 吕佳仁 KE Jianhui;LIN Yijian;ZHANG Guoxin;CAI Honghong;LYU Jiaren(Department of Geriatrics,Fuzhou Changle District Hospital,Fuzhou,Fujian Province,350200 China;Department of Respiratory and Critical Care Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian Province,362000 China;Department of Geriatrics,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian Province,362000 China;Department of Pediatrics,Jinjiang Hospital,Quanzhou,Fujian Province,362299 China;Department of Electrocardiographic Room,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian Province,362000 China)

机构地区：[1]福州市长乐区医院老年病科,福建福州350200 [2]福建医科大学附属泉州第一医院呼吸与危重症医学科,福建泉州362000 [3]福建医科大学附属泉州第一医院老年病科,福建泉州362000 [4]晋江市医院儿科,福建泉州362299 [5]福建医科大学附属泉州第一医院心电图室,福建泉州362000

出　　处：《中外医疗》2022年第33期5-9,共5页China & Foreign Medical Treatment

摘　　要：目的研究慢阻肺高碳酸血症老年患者应用无创正压通气(non-invasive positive pressure ventilation,NPPV)、经鼻高流量氧疗(high flow oxygen therapy,HFNC)的疗效。方法方便选取2020年1月-2021年12月福州市长乐区医院收治的88例慢阻肺高碳酸血症老年患者为研究对象,根据治疗方法的不同将其分为两组。N组(44例)采用NPPV治疗,H组(44例)采用HFNC治疗,观察比较两组患者生命体征指标、动脉血气指标、血钠血钾水平、临床治疗效果及不良反应发生情况。结果治疗后,H组心率、呼吸频率、血压水平及动脉血二氧化碳分压(PaCO_(2))均低于N组,动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))血钠及血钾均高于N组,差异有统计学意义(P<0.05)。H组治疗总有效率为95.45%,高于N组的79.55%,H组不良反应发生率为11.36%,低于N组的38.64%,差异有统计学意义(χ^(2)=5.091、8.727,P<0.05)。结论慢阻肺高碳酸血症老年患者采用HFNC治疗的效果更佳,可有效改善患者动脉血气指标,且安全性较高。Objective To study the efficacy of non-invasive positive pressure ventilation(NPPV)and nasal high flow oxygen therapy(HFNC)in elderly patients with COPD hypercapnia.Methods 88 elderly patients with COPD hypercapnia admitted to Fuzhou Changle District Hospital from January 2020 to December 2021 were conveniently selected as the study objects,and divide them into two groups according to different treatment methods.Group N(44 cases)received NPPV treatment,and group H(44 cases)received HFNC treatment.The vital signs index,arterial blood gas index,blood sodium and potassium level,clinical therapeutic effect and the occurrence of adverse reactions were observed and compared between the two groups.Results After treatment,the heart rate,respiratory rate,blood pressure level and partial pressure of carbon dioxide(PaCO_(2))in group H were lower than those of the group N,and the partial arterial oxygen pressure(PaO_(2)),saturation of pulse oximetry(SpO_(2)),blood sodium and blood potassium were higher than those of the group N,the difference was statistically significant(P<0.05).The total effective rate in group H(95.45%)was higher than that in group N(79.55%),and the incidence of adverse reactions in group H(11.36%)was lower than that in group N(38.64%),the difference was statistically significant(χ^(2)=5.091,8.727,P<0.05).Conclusion HFNC treatment in elderly patients with chronic obstructive pulmonary hypercapnia has better effect,which can effectively improve patients'arterial blood gas indexes and has high safety.

关 键 词：慢性阻塞性肺疾病 高碳酸血症 经鼻高流量氧疗 无创正压通气 动脉血气 

分 类 号：R4[医药卫生—临床医学]