NIPPV联合HFNC在呼吸衰竭合并心力衰竭患者中的应用  

Application of NIPPV Combined with HFNC in Patients with Respiratory Failure and Heart Failure

作　　者：张森 梁松荣 王华洪 卢月梅 ZHANG Sen;LIANG Songrong;WANG Huahong;LU Yuemei(Department of Respiratory and Critical Care Medicine,Luoding People's Hospital,Luoding 527200,China;不详)

机构地区：[1]罗定市人民医院呼吸与危重症医学科,广东罗定527200 [2]罗定市人民医院消化内科,广东罗定527200 [3]罗定市人民医院肿瘤科,广东罗定527200

出　　处：《中国医学创新》2024年第18期32-36,共5页Medical Innovation of China

基　　金：云浮市医药卫生科技计划项目(WS2021030105)。

摘　　要：目的:探讨无创正压通气(NIPPV)联合经鼻高流量湿化氧疗(HFNC)在呼吸衰竭合并心力衰竭患者中的应用效果。方法:选取2021年6月—2023年5月罗定市人民医院收治的90例呼吸衰竭合并心力衰竭患者,按随机数字表法分为三组,各30例。对照1组予以NIPPV治疗,对照2组予以HFNC治疗,观察组予以NIPPV联合HFNC治疗。比较三组临床疗效、血气指标、脑钠肽(BNP)水平、炎症因子水平及并发症发生情况。结果:观察组总有效率高于对照1组、对照2组,差异均有统计学意义(P<0.05)。治疗后,观察组动脉血氧分压(PaO_(2))高于对照1组、对照2组,动脉血二氧化碳分压(PaCO_(2))、BNP、白细胞计数(WBC)、C反应蛋白(CRP)、中性粒细胞比值(NE%)均低于对照1组、对照2组,差异均有统计学意义(P<0.05)。观察组、对照2组并发症总发生率均低于对照1组,差异均有统计学意义(P<0.05)。结论:NIPPV联合HFNC可提高呼吸衰竭合并心力衰竭患者疗效,加快动脉血气复常,减轻炎症损伤,减少并发症发生。Objective:To investigate the effect of non-invasive positive pressure ventilation(NIPPV)combined with high-flow nasal cannula(HFNC)in patients with respiratory failure and heart failure.Method:A total of 90 patients with respiratory failure and heart failure admitted to Luoding People's Hospital from June 2021 to May 2023 were selected and divided into three groups according to random number table method,with 30 patients in each group.Control group 1 was treated with NIPPV,control group 2 was treated with HFNC,and observation group was treated with NIPPV combined with HFNC.The clinical efficacy,blood gas index,brain natriuretic peptide(BNP)level,inflammation index level and complications of the three groups were compared.Result:The total effective rate of observation group was higher than that of control group 1 and control group 2,the differences were statistically significant(P<0.05).After treatment,the blood oxygen partial pressure(PaO_(2))of observation group was higher than that of control group 1 and control group 2,and the partial pressure of carbon dioxide(PaCO_(2)),BNP,white blood cell count(WBC),C reactive protein(CRP)and neutrophil ratio(NE%)of observation group were lower than those of control group 1 and control group 2,the differences were statistically significant(P<0.05).The total incidence of complications in observation group and control group 2 was lower than that in control group 1,the differences were statistically significant(P<0.05).Conclusion:NIPPV combined with HFNC can improve the efficacy of patients with respiratory failure and heart failure,accelerate arterial blood gas normalization,reduce inflammatory damage,and reduce complications.

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 

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