经鼻高流量湿化氧疗与无创正压通气治疗AECOPD合并呼吸衰竭的临床疗效比较  

Comparison of Clinical Efficacy between Nasal High Flow Humidified Oxygen Therapy and Non-invasive Positive Pressure Ventilation in the Treatment of AECOPD Complicated with Respiratory Failure

作　　者：白莹 王作飞 孙静 BAI Ying;WANG Zuofei;SUN Jing(Department of Pulmonary and Critical Care Medicine,Shandong Guoxin Yiyang Group Zaozhuang Hospital,Zaozhuang 277100,China;Department of Respiratory and Critical Care Medicine,Shizhong District People's Hospital of Zaozhuang City,Zaozhuang 277100,China;Department of Respiratory and Critical Care Medicine,Zaozhuang Municipal Hospital,Zaozhuang 277100,China)

机构地区：[1]山东国欣颐养集团枣庄医院呼吸与危重症医学科,山东枣庄277100 [2]山东省枣庄市市中区人民医院呼吸与危重症医学科,山东枣庄277100 [3]山东省枣庄市市立医院呼吸与危重症医学科,山东枣庄277100

出　　处：《中国医药指南》2023年第27期92-94,98,共4页Guide of China Medicine

摘　　要：目的对比分析经鼻高流量湿化氧疗与无创正压通气治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的疗效。方法选择2021年1月至2023年1月我院收治的AECOPD合并呼吸衰竭患者112例,随机分为两组,各56例。对照组行无创正压通气治疗,试验组行经鼻高流量湿化氧疗治疗。对比两组治疗前后生命体征、血气指标、氧化应激水平变化,并统计不良反应发生率。结果两组治疗后生命体征、血气指标、氧化应激水平均明显改善(P<0.05)。试验组治疗后心率、呼吸频率、平均动脉压与对照组相比,差异无统计学意义(P>0.05)。试验组治疗后动脉血氧分压、动脉血氧饱和度、pH值高于对照组,动脉血二氧化碳分压低于对照组(P<0.05)。试验组治疗后SOD、GSH-Px高于对照组,MDA低于对照组(P<0.05)。试验组总不良反应发生率低于对照组(P<0.05)。结论经鼻高流量湿化氧疗治疗AECOPD合并呼吸衰竭患者疗效优于无创正压通气治疗,前者改善患者血气指标及氧化应激水平效果更优,且不良反应少。Objective To compare and analyze the efficacy of nasal high flow humidified oxygen therapy and non-invasive positive pressure ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with respiratory failure.Methods The 112 AECOPD patients with respiratory failure admitted to our hospital from January 2021 to January 2023 were randomly divided into two groups,with 56 patients in each group.The control group received non-invasive positive pressure ventilation treatment,while the experimental group received nasal high flow humidified oxygen therapy.Compare the changes in vital signs,blood gas indicators,and oxidative stress levels between the two groups before and after treatment,and calculate the incidence of adverse reactions.Results After treatment,both groups showed significant improvements in vital signs,blood gas indicators,and oxidative stress water on average(P<0.05).There was no significant difference in heart rate,respiratory rate and mean arterial pressure between the test group and the control group after treatment(P>0.05).After treatment,the arterial partial pressure of oxygen,arterial oxygen saturation and pH value in the test group were higher than those in the control group,and the arterial blood partial pressure of carbon dioxide was lower than that in the control group(P<0.05).After treatment,SOD and GSH-Px in the experimental group were higher than those in the control group,while MDA was lower than those in the control group(P<0.05).The total incidence of adverse reactions in the experimental group was lower than that in the control group(P<0.05).Conclusion The therapeutic effect of nasal high flow humidified oxygen therapy on AECOPD patients with respiratory failure is superior to non-invasive positive pressure ventilation therapy.The former has a better effect on improving blood gas indicators and oxidative stress levels in patients,and has fewer adverse reactions.

关 键 词：经鼻高流量湿化氧疗 无创正压通气 AECOPD 呼吸衰竭 疗效 

分 类 号：R563.8[医药卫生—呼吸系统]