茶碱类药物静脉滴注联合高流量呼吸湿化治疗仪对老年慢性阻塞性肺疾病继发Ⅱ型呼吸衰竭患者血清降钙素原、乳酸清除率的影响  

Effects of intravenous infusion of theophylline drugs combined with high-flow respiratory humidifier on serum procalcitonin and lactate clearance rates in elderly patients with COPD secondary to typeⅡrespiratory failure

作　　者：冯旭 孙建平 姜鑫 许小 山肖子亚 Feng Xu;Sun Jianping;Jiang Xin;Xu Xiaoshan;Xiao Ziya(Emergency Intensive Care Unit,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Emergency,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院急诊监护室,济宁272029 [2]济宁医学院附属医学影像科,济宁272029 [3]济宁医学院附属医院急诊科,济宁272029

出　　处：《中国医师杂志》2023年第6期869-874,共6页Journal of Chinese Physician

摘　　要：目的观察茶碱类药物静脉滴注联合高流量呼吸湿化治疗仪对老年慢性阻塞性肺疾病(COPD)继发Ⅱ型呼吸衰竭患者血清降钙素原(PCT)、乳酸清除率(LCR)的影响。方法前瞻性选取济宁医学院附属医院于2020年3月至2022年3月收治的老年COPD继发Ⅱ型呼吸衰竭患者120例,采用随机数字表法分为对照组(n=60)和观察组(n=60),对照组给予无创正压通气联合茶碱类药物静脉滴注治疗,观察组给予高流量呼吸湿化治疗仪联合茶碱类药物静脉滴注治疗。统计两组痰液黏稠度,比较两组治疗后的肺功能[用力肺活量(FVC)、1 s用力呼气容积(FEV1)、FEV1/FVC]、血气分析、呼吸力学、氧代谢及血清学指标水平、急性生理学与慢性健康评估Ⅱ(APACHEⅡ)评分的差异。结果观察组整体痰液黏稠度优于对照组(P<0.05)。治疗前,两组肺功能、血气分析指标差异无统计学意义(均P>0.05);治疗后,两组肺功能指标、动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))均较治疗前明显升高(均P<0.05),而动脉血二氧化碳分压(PaCO_(2))较治疗前明显下降(均P<0.05),且观察组各指标升高或下降后的数值明显优于对照组(均P<0.05)。治疗前,两组呼吸力学、氧代谢指标差异无统计学意义(均P>0.05);治疗后,两组动脉血氧含量(CaO_(2))较治疗前明显升高(均P<0.05),而两组氧摄取率(ERO_(2))和观察组最大摄氧量(VO_(2)Max)、气道峰值、呼吸阻力较治疗前明显下降(均P<0.05),且观察组各指标升高或下降后的数值明显优于对照组(均P<0.05)。治疗前,两组血清学指标、APACHEⅡ评分差异无统计学意义(均P>0.05);治疗后,观察组LCR较治疗前明显升高(P<0.05),而PCT、白细胞介素-6(IL-6)、C反应蛋白(CRP)及APACHEⅡ评分较治疗前明显下降(均P<0.05),且观察组各指标升高或下降后的数值明显优于对照组(均P<0.05)。结论茶碱类药物静脉滴注联合高流量呼吸湿化治疗仪治疗老年COPD�Objective To observe the effect of theophylline intravenous drip combined with high flow respiratory humidifier on serum pro Calcitonin(PCT)and lactate clearance rate(LCR)in elderly patients with chronic obstructive pulmonary disease(COPD)secondary to type II respiratory failure.Methods We prospectively selected 120 elderly patients with COPD secondary to type II respiratory failure who were admitted to the Affiliated Hospital of Jining Medical University from March 2020 to March 2022.They were randomly divided into the control group(n=60)and the observation group(n=60).The control group was treated with non-invasive positive pressure ventilation combined with theophylline intravenous drip,and the observation group was treated with high flow respiratory humidification therapy apparatus combined with theophylline intravenous drip.The sputum viscosity of the two groups was counted,and the pulmonary function[forced vital capacity(FVC),forced expiratory volume in 1 s(FEV1),FEV1/FVC],blood gas analysis,respiratory mechanics,oxygen metabolism,and serum index levels,as well as the difference between acute physiology and chronic health assessmentⅡ(APACHEⅡ)scores after treatment were compared between the two groups.Results The overall sputum viscosity of the observation group was better than that of the control group(P<0.05).Before treatment,there was no statistically significant difference in lung function and blood gas analysis indicators between the two groups(all P>0.05);After treatment,the lung function indicators,arterial partial pressure of oxygen(PaO_(2)),and oxygenation index(PaO_(2)/FiO_(2))of both groups were significantly increased compared to before treatment(all P<0.05),while arterial partial pressure of carbon dioxide(PaCO_(2))was significantly decreased compared to before treatment(all P<0.05),and the values of each indicator in the observation group after increasing or decreasing were significantly better than those in the control group(all P<0.05).Before treatment,there was no statistically significa

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 茶碱 高流量呼吸湿化仪 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]