失血性休克并发ARDS患者应用HFNC与NPPV治疗的临床效果对比研究  

Comparative study on the clinical efficacy of HFNC and NPPV treatment in patients with hemorrhagic shockcomplicated byARDS

作　　者：宋小娟[1] 徐秋燕[1] 劳永光[1] Song Xiaojuan;Xu Qiuyan;Lao Yongguang(Surgical Intensive Care Unit of Zhanjiang Central People's Hospital,Zhanjiang,China.)

机构地区：[1]湛江中心人民医院外科重症监护病房

出　　处：《实用休克杂志（中英文）》2023年第5期278-281,共4页Journal of Practical Shock

摘　　要：目的对比分析失血性休克并发急性呼吸窘迫综合征(ARDS)患者应用经鼻湿化高流量氧疗(HFNC)与无创正压通气(NPPV)的临床效果。方法将2018年1月~2022年12月本院救治的80例失血性休克并发ARDS患者随机分为HFNC组和NPPV组各40例,HFNC组患者实施HFNC治疗,NPPV组患者实施NPPV治疗。比较治疗前和治疗48h后两组患者的血氧指标(动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、氧合指数(OI))、生命体征(收缩压(SBP)、舒张压(DBP))、炎症因子(C-反应蛋白(CRP)、血栓素A2(TXA2)、白介素-6(IL-6)水平。结果治疗48h后,两组患者PaO_(2)、OI、SBP、DBP水平明显高于治疗前,且相较于NPPV组疗效优于HFNC组(P<0.05)。两组PaCO_(2)、CRP、TXA2、IL-6水平显著低于治疗前,且HFNC组疗效更佳(P<0.05)。结论与NPPV治疗效果比较,失血性休克并发ARDS患者使用HFNC治疗可明显改善血氧指标和生命体征,为效果优良的无创氧疗方案。Objective To compare and analyze the clinical effects of nasal humidification high flow oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NPPV)on patients with hemorrhagic shock complicated by acute respiratory distress syndrome(ARDS).Methods 80patients with hemorrhagic shock complicated with ARDS treated in our hospital from January 2018 to December 2022 were randomly divided into HFNC group and NPPV group with 40 patients each.HFNC group patients received HFNC treatment,while NPPV group patients received NPPV treatment.Compare the levels of blood oxygen indicators(PaO_(2),PaCO_(2),OI),vital signs(SBP,DBP),inflammatory factors(C-reactive protein(CRP),thromboxane A2(TXA2),and interleukin-6(IL-6))between the two groups of patients before and 48 hours after treatment.Results After 48 hours of treatment,the levels of PaO_(2)OI,SBP,and DBP in both groups of patients were significantly higher than before treatment,and the therapeutic effect was better than that of the HFNC group compared to the NPPV group(P<0.05).The levels of PaCO_(2),CRP,TXA2,and IL-6 in both groups were significantly lower than before treatment,and the HFNC group had better efficacy(P<0.05).Conclusions Compared with NPPV treatment,HFNC treatment can significantly improve blood oxygen indicators and vital signs in patients with hemorrhagic shock complicated by ARDS,making it an effective non-invasive oxygen therapy regimen.

关 键 词：经鼻湿化高流量氧疗 无创正压通气 失血性休克 急性呼吸窘迫综合征 

分 类 号：R563.8[医药卫生—呼吸系统] R605.971[医药卫生—内科学]