经鼻高流量氧疗与无创正压通气治疗COPD合并Ⅱ型呼吸衰竭的临床疗效对比  

Comparison of Clinical Efficacy of Nasal High Flow Oxygen Therapy and Non-invasive Positive Pressure Ventilation in the Treatment of COPD Complicated with TypeⅡRespiratory Failure

作　　者：杨俊英 张伟华[1] 张春玲[1] 孙颖[2] YANG Jun-ying;ZHANG Wei-hua;ZHANG Chun-ling;SUN Ying(Respiratory and Critical Care Department,First People's Hospital of Shangqiu,Shangqiu 476100,Henan Province,China;Henan University of Chinese Medicine School of Medicine,Zhengzhou 450099,Henan Province,China)

机构地区：[1]商丘市第一人民医院呼吸与危重症科,河南商丘476100 [2]河南中医药大学医学院,河南郑州450099

出　　处：《罕少疾病杂志》2025年第3期57-59,共3页Journal of Rare and Uncommon Diseases

基　　金：国家自然科学基金项目(81803863);河南省医学科技攻关计划(联合共建)项目(LHGJ20191500);河南省医学科技攻关计划(联合共建)项目(LHGJ20191501)。

摘　　要：目的 分析并对比经鼻高流量氧疗(HFNC)与无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的临床疗效。方法 将商丘市第一人民医院呼吸与危重症科于2021年10月至2023年9月收治的80例COPD合并Ⅱ型呼吸衰竭患者随机分为两组,即对照组(给予NIPPV治疗)和观察组(给予HFNC治疗),每组40例。比较两组患者各项治疗指标的差异。结果 治疗后,观察组与对照组治疗总有效率分别为87.50%、82.50%,对比差异不显著(P>0.05);观察组动脉血PH值、PaO_(2)水平以及肺功能指标(FEV1、FVC、FEV1/FVC)均高于对照组,而PaCO_(2)水平低于对照组(P<0.05);观察组不良事件发生率为5.00%(2/40),低于对照组的20.00%(8/40)(P<0.05);观察组患者有创机械通气率低于对照组,总住院时间短于对照组(P<0.05)。结论 给予COPD合并Ⅱ型呼吸衰竭患者经鼻高流量氧疗和无创正压通气治疗均能取得良好的治疗效果,但应用经鼻高流量氧疗不仅能够更好地改善患者动脉血气指标与肺功能,同时还能减少不良事件的发生,降低有创机械通气率以及缩短住院时间,值得推广。Objective To analyze and compare the clinical efficacy of nasal high flow oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)in the treatment of chronic obstructive pulmonary disease(COPD)complicated with typeⅡrespiratory failure.Methods 80 patients with COPD combined with typeⅡrespiratory failure admitted to the Respiratory and Critical Care Department of Shangqiu First People's Hospital from October 2021 to September 2023 were randomly divided into two groups,namely control group(treated with NIPPV)and observation group(treated with HFNC),with 40 cases in each group.The differences of treatment indexes between the two groups were compared.Results After treatment,the total effective rate of observation group and control group was 87.50%and 82.50%,respectively,with no significant difference(P>0.05).Arterial blood PH,PaO_(2) level and pulmonary function indexes(FEV1,FVC,FEV1/FVC)of the observed group were higher than those of the control group,but the PaCO_(2) level was less than that of the control group(P<0.05).The incidence of adverse events in observation group was 5.00%(2/40),which was lower than that in control group20.00%(8/40)(P<0.05).The invasive mechanical ventilation rate of observation group was lower than that of control group,and the total hospital stay was shorter than that of control group(P<0.05).Conclusion Both nasal high-flow oxygen therapy and non-invasive positive pressure ventilation can achieve good therapeutic effects in patients with COPD complicated with typeⅡrespiratory failure.However,the application of nasal high-flow oxygen therapy can not only better improve the arterial blood gas index and lung function of patients,but also reduce the occurrence of adverse events,reduce the rate of invasive mechanical ventilation and shorten the length of hospital stay,which is worth promoting.

关 键 词：经鼻高流量氧疗 无创正压通气 COPD Ⅱ型呼吸衰竭 

分 类 号：R563.8[医药卫生—呼吸系统]