NIPPV联合HFNC对心力衰竭合并呼吸衰竭患者的影响  

Effect of NIPPV Combined with HFNC on Patients with Heart Failure and Respiratory Failure

作　　者：张森 梁松荣 王华洪 卢月梅 ZHANG Sen;LIANG Songrong;WANG Huahong;LU Yuemei(Luoding People's Hospital,Luoding 527200,China)

机构地区：[1]罗定市人民医院,广东罗定527200

出　　处：《中外医学研究》2023年第30期117-120,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：云浮市医药卫生科技计划项目(WS2021030105)。

摘　　要：目的:研究无创正压通气(NIPPV)联合经鼻高流量湿化氧疗(HFNC)对心力衰竭合并呼吸衰竭患者的影响。方法:选取2021年12月—2022年12月罗定市人民医院收治的102例心力衰竭合并呼吸衰竭患者作为研究对象。根据随机数表法将其分为NIPPV组、HFNC组和联合组,各34例。NIPPV组给予NIPPV,HFNC组给予HFNC,联合组给予NIPPV联合HFNC治疗。比较三组治疗前及治疗48 h的血气指标、血流动力学指标、病情严重程度、舒适度。结果:治疗48 h,三组氧合指数、动脉血氧分压(PaO_(2))均升高,动脉血二氧化碳分压(PaCO_(2))均降低,联合组氧合指数、PaO_(2)均高于NIPPV组、HFNC组,PaCO_(2)低于NIPPV组、HFNC组,差异有统计学意义(P<0.05)。治疗48 h,三组心率(HR)、呼吸频率(RR)均降低,HFNC组、联合组HR、RR均低于NIPPV组,差异有统计学意义(P<0.05)。治疗48 h,三组急性生理与慢性健康(APACHEⅡ)评分均降低,伯格曼舒适度评分(BCS)评分均升高,联合组APACHEⅡ评分低于NIPPV组、HFNC组,BCS评分高于NIPPV组、HFNC组,差异有统计学意义(P<0.05)。结论:NIPPV联合HFNC能改善心力衰竭合并呼吸衰竭患者氧合指数、血流动力学,减轻病情严重程度,提升呼吸舒适度。Objective:To study the effect of non-invasive positive pressure ventilation(NIPPV)combined with high-flow nasal cannula oxygen therapy(HFNC)on patients with heart failure and respiratory failure.Method:A total of 102 patients with heart failure and respiratory failure treated in Luoding People's Hospital from December 2021 to December 2022 were selected as the study objects.They were divided into NIPPV group,HFNC group and combined group according to random number table method,with 34 cases in each group.The NIPPV group was given NIPPV,the HFNC group was given HFNC,and the combined group was given NIPPV combined with HFNC.Blood gas index,hemodynamic index,severity of disease and comfort level were compared among the three groups before treatment and at 48 h of treatment.Result:At 48 h of treatment,the oxygenation index and arterial partial pressure of oxygen(PaO_(2))of the three groups were increased,and the arterial partial pressure of carbon dioxide(PaCO_(2))of the three groups were decreased,the oxygenation index and PaO_(2) of the combined group were higher than those of NIPPV group and HFNC group,and the PaCO_(2) was lower than that of NIPPV group and HFNC group,the differences were statistically significant(P<0.05).At 48 h of treatment,the heart rate(HR)and respiratory rate(RR)of the three groups were decreased,and the HR and RR of HFNC group and combined group were lower than those of NIPPV group,the differences were statistically significant(P<0.05).At 48 h of treatment,the acute physiological and chronic health(APACHEⅡ)scores of the three groups were decreased,and the Bruggrmann comfort scale(BCS)scores were increased,the APACHEⅡscore of the combined group was lower than that of NIPPV group and HFNC group,and the BCS score was higher than that of NIPPV group and HFNC group,the differences were statistically significant(P<0.05).Conclusion:NIPPV combined with HFNC can improve the oxygenation index,hemodynamics of patients with heart failure and respiratory failure,reduce the degree of illness,and impro

关 键 词：呼吸衰竭 心力衰竭 无创正压通气 经鼻高流量湿化氧疗 氧合指数 血气指标 

分 类 号：R541.6[医药卫生—心血管疾病] R563.8[医药卫生—内科学]