高流量湿化联合呼吸兴奋剂治疗AECOPD合并Ⅱ型呼吸衰竭的疗效观察  

Efficacy observation of high flow humidification combined with respiratory stimulants in the treatment of AECOPD with typeⅡrespiratory failure

作　　者：陈亚宽 张海清[1] 林杰 吴卓荣 CHEN Ya-kuan;ZHANG Hai-qing;LIN Jie(Zhaoqing Second People's Hospital,Zhaoqing 526060,China)

机构地区：[1]肇庆市第二人民医院,526060

出　　处：《中国实用医药》2024年第7期113-116,共4页China Practical Medicine

摘　　要：目的探讨高流量湿化联合呼吸兴奋剂治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的疗效。方法78例AECOPD合并Ⅱ型呼吸衰竭患者,按随机数字表法分为对照组与观察组,每组39例。对照组使用BiPAP无创呼吸机通气治疗,观察组使用高流量湿化联合呼吸兴奋剂治疗。对比两组的临床疗效、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))、氧合指数(OI)]、住院时间、心率(HR)及呼吸频率(RR)。结果观察组治疗总有效率为94.87%,明显高于对照组的74.36%(P<0.05)。治疗后,观察组PaO_(2)(85.37±7.29)mm Hg(1 mm Hg=0.133 kPa)、OI(296.83±31.95)mm Hg、SaO_(2)(92.54±4.18)%高于对照组的(76.41±7.90)mm Hg、(257.48±29.63)mm Hg、(85.73±4.49)%,PaCO_(2)(39.54±5.47)mm Hg低于对照组的(50.72±6.31)mm Hg(P<0.05)。治疗后,观察组HR(70.36±5.41)次/min、RR(18.90±1.24)次/min均低于对照组的(82.94±7.52)、(22.97±2.01)次/min(P<0.05);观察组住院时间(7.21±1.75)d短于对照组的(13.68±2.49)d(P<0.05)。结论与BiPAP无创呼吸机通气治疗相比,高流量湿化联合呼吸兴奋剂治疗AECOPD合并Ⅱ型呼吸衰竭的疗效显著,能有效改善血气指标,提升肺通气功能,缩短住院时间。Objective To explore the efficacy of high flow humidification combined with respiratory stimulants in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with typeⅡrespiratory failure.Methods 78 patients with AECOPD and typeⅡrespiratory failure were divided into a control group and an observation group according to random number table method,with 39 cases in each group.The control group was treated with BiPAP non-invasive ventilator,and the observation group was treated with high flow humidification and respiratory stimulants.Both groups were compared in terms of clinical efficacy,blood gas analysis indicators[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SaO_(2)),oxygenation index(OI)],length of hospital stay,heart rate(HR)and respiratory rate(RR).Results The total effective rate of the observation group was 94.87%,which was significantly higher than 74.36%of the control group(P<0.05).After treatment,the observation group PaO_(2)of(85.37±7.29)mm Hg(1 mm Hg=0.133 kPa),OI of(296.83±31.95)mm Hg,SaO_(2)of(92.54±4.18)%,which were higher than(76.41±7.90)mm Hg,(257.48±29.63)mm Hg,(85.73±4.49)%in the control group;the observation group had lower PaCO_(2)of(39.54±5.47)than(50.72±6.31)mm Hg in the control group(P<0.05).After treatment,the observation group had HR of(70.36±5.41)beats/min and RR of(18.90±1.24)times/min,which were lower than(82.94±7.52)beats/min and(22.97±2.01)times/min in the control group(P<0.05).The length of hospital stay in the observation group was(7.21±1.75)d,which was shorter than(13.68±2.49)d in the control group(P<0.05).Conclusion Compared with BiPAP non-invasive ventilator ventilation,high-flow humidification combined with respiratory stimulants has significant efficacy in the treatment of AECOPD with typeⅡrespiratory failure,which can effectively improve the blood gas indicators,enhance the lung ventilation function and shorten the length of hospital stay.

关 键 词：慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 高流量湿化 呼吸兴奋剂 疗效 

分 类 号：R563[医药卫生—呼吸系统]