经鼻高流量加温湿化吸氧联合丹参注射液治疗AECOPD合并轻度Ⅱ型呼吸衰竭的效果及对血气、肺功能的影响分析  

Effects of Nasal High Flow Warming Humidification Oxygen Inhalation Combined with Salvia Miltiorrhiza Injection in the Treatment of AECOPD with Mild Type II Respiratory Failure and Its Impact on Blood Gas and Lung Function

作　　者：排合日丁·卡米力江 安外尔·阿皮孜 李建[1] 杨春波[1] 柴瑞峰[1] Paihe Riding·Kamilijan;Anwel·Apiz;LI Jian;YANG Chun-bo;CHAI Rui-feng(Department of Critical Care Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学一科,新疆乌鲁木齐830054

出　　处：《现代生物医学进展》2024年第4期665-669,共5页Progress in Modern Biomedicine

基　　金：新疆维吾尔自治区自然科学基金项目(2020D01C233)。

摘　　要：目的:探讨经鼻高流量加温湿化吸氧联合丹参注射液治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并轻度Ⅱ型呼吸衰竭的效果及对患者血气、肺功能的影响。方法:按照随机数字表法将本院重症医学一科在2020年3月至2023年2月期间收治的88例AECOPD合并轻度Ⅱ型呼吸衰竭患者分为对照组和观察组,各44例。两组均采用经鼻高流量加温湿化吸氧治疗,在此基础上给予观察组患者丹参注射液滴注。比较两组患者临床疗效以及治疗前后血气指标[动脉血氧分压(PaO_(2))和动脉二氧化碳分压(PaCO_(2))]、肺功能指标[1 s用力呼气量(FEV_(1)、FEV_(1))/用力肺活量(FEV_(1)/FVC)和FEV_(1)占预计值百分比(FEV_(1)%)]、炎性因子[白介素6(IL-6)、IL-8、肿瘤坏死因α(TNF-α)]和血清生化指标[转化生长因子β1(TGF-β1)、内皮素-1(ET-1)、缔组织生长因子(CTGF)]水平。结果:(1)观察组总有效率高于对照组(P<0.05)。(2)两组治疗后PaO_(2)显著增加,PaCO_(2)显著降低(P<0.05),观察组治疗后PaO_(2)较对照组高,PaCO_(2)较对照组低(P<0.05)。(3)两组治疗后FEV_(1)、FEV_(1)/FVC、FEV_(1)%均显著增加(P<0.05)。观察组患者较对照组高(P<0.05)。(4)两组治疗后血清IL-6、IL-8和TNF-α水平均显著降低(P<0.05)。观察组患者治疗后较对照组低(P<0.05)。(5)两组治疗后血清TGF-β1、ET-1和CTGF水平均显著降低(P<0.05)。观察组患者治疗后血清TGF-β1、ET-1和CTGF水平均显著低于对照组(P<0.05)。结论:经鼻高流量加温湿化吸氧联合丹参注射液治疗AECOPD合并Ⅱ型呼吸衰竭疗效肯定,改善患者血气和肺功能,减轻炎性反应。Objective:To explore the effect of nasal high flow warming humidification oxygen inhalation combined with salvia miltiorrhiza injection in the treatment of AECOPD with mild type II Respiratory failure and the impact on blood gas and lung function of patients.Methods:88 AECOPD patients with mild type II Respiratory failure admitted to the First Department of Intensive care medicine of our hospital from March 2020 to February 2023 were divided into the matched group and the observation group,with 44 cases in each group.Both groups were treated with nasal high flow heating and humidification oxygen inhalation,and on this basis,the observation group patients were given Danshen injection drops.The clinical efficacy of the two groups of patients was compared,as well as the blood gas indicators[arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))],pulmonary function indicators[1 s forced expiratory volume(FEV_(1)),FEV_(1)/forced Vital capacity(FEV_(1)/FVC)and FEV_(1)%of the estimated value],inflammatory factors[interleukin 6(IL-6),IL-8,tumor necrosis factorα(TNF-α)]and serum biochemical indicators[transforming growth factorβ1(TGF-β1)Endothelin-1(ET-1),connective tissue growth factor(CTGF)]levels.Results:(1)The total effective rates of observation group higher than matched group(P<0.05).(2)After treatment,PaO_(2) significantly increased and PaCO_(2) decreased in both groups(P<0.05).After treatment,observation group was higher than matched group,while PaCO_(2) was significantly lower than matched group(P<0.05).(3)After treatment,FEV_(1),FEV_(1)/FVC,and FEV_(1)%increased in both groups(P<0.05).observation group were higher than matched group after treatment(P<0.05).(4)The levels of serum IL-6,IL-8,and TNF-αafter treatment in two groups were significantly reduced(P<0.05).The levels of serum IL-6,IL-8,and TNF-αin observation group after treatment were lower than matched group(P<0.05).(5)The levels of serum TGF-β1,ET-1 and CTGF of the two groups after treatment were sign

关 键 词：AECOPD Ⅱ型呼吸衰竭 经鼻高流量加温湿化吸氧 丹参注射液 血气 肺功能 

分 类 号：R563.8[医药卫生—呼吸系统]