经鼻高流量氧疗与无创正压通气改善急性呼吸衰竭患者二氧化碳潴留的临床疗效  

Comparison of clinical efficacy of high flow nasal qxygen and non invasive positive pressure ventilation in improving carbon dioxide retention in patients with acute respiratory failure

作　　者：易斐斐 郑书伊 YI Feifei;ZHENG Shuyi(Respiratory and Critical Care Zone 1,Ganzhou Fifth People's Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市第五人民医院呼吸与危重症一区,江西赣州341000

出　　处：《当代医学》2023年第33期99-102,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF305)。

摘　　要：目的探讨经鼻高流量氧疗(HFNC)与无创正压通气(NPPV)改善急性呼吸衰竭患者二氧化碳潴留的临床疗效。方法选取2019年11月至2021年11月赣州市第五人民医院收治的76例急性呼吸衰竭患者作为研究对象,按照随机数字表法分为观察组与对照组,每组38例。对照组采用NPPV治疗,观察组采用HFNC治疗,比较两组血气分析结果[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、呼吸力学指标[潮气量(VT)、每分钟通气量(MV)、吸气/呼吸周期时间比(Ti/T)]、临床治疗时间。结果治疗后2、6、24及48 h,观察组PaO_(2)、Pa�CO_(2)水平均低于对照组,差异有统计学意义(P<0.05)。治疗后24 h,两组VT、Ti/T、MV均大于治疗前,且观察组VT大于对照组,但Ti/T小于对照组,差异有统计学意(P<0.05);两组MV比较差异无统计学意义。观察组氧疗时间与住院时间均短于对照组,差异有统计学意义(P<0.05)。结论HFNC与NPPV治疗急性呼吸衰竭二氧化碳潴留效果相当,但HFNC对呼吸动力学的改善效果更佳,且可缩短住院时间与氧疗时间,值得临床推广应用。Objective To investigate the clinical efficacy of high flow nasal qxygen(HFNC)and non invasive positive pressure ventilation(NPPV)in improving carbon dioxide retention in patients with acute respiratory failure.Methods 76 patients with acute respiratory failure admitted to the Fifth People's Hospital of Ganzhou from November 2019 to November 2021 were selected as the study subjects,they were divided into the observation group and the control group according to random number table method,with 38 cases in each group.The control group received NPPV treatment,while the observation group received HFNC treatment.The results of blood gas analysis(arterial blood oxygen partial pressure[PaO_(2)],arterial blood carbon dioxide partial pressure[PaCO_(2)]),respiratory mechanics indicators(tidal volume[VT],minute ventilation volume[MV],inspiratory/respiratory cycle time ratio[Ti/T]),and clinical treatment time were compared between the two groups.Results At 2,6,24 and 48 h after treatment,the levels of PaO_(2) and PaCO_(2) in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At 24 h after treatment,VT,Ti/T and MV of the two groups were higher than those before treatment,and VT in the observation group was higher than that in the control group,but Ti/T was lower than that in the control group,the differences were statistically significant(P<0.05);there was no significant difference in MV between the two groups.The oxygen therapy time and hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The effect of HFNC and NPPV in the treatment of acute respiratory failure with carbon dioxide retention is similar,but HFNC has better effect on the improvement of respiratory dynamics,and can shorten the hospitalization time and oxygen therapy time,which is worthy of clinical promotion and application.

关 键 词：急性呼吸衰竭 二氧化碳潴留 经鼻高流量氧疗 无创正压通气 呼吸动力学 

分 类 号：R563.8[医药卫生—呼吸系统]