经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.     

信心是半个生命

有位诗人说:“信心是半个生命,淡漠是半个死亡。”我很欣赏他的观点。我认为,老年人健康长寿的因素固然很多,但信心是重要的一条。有健全的精神,才有健康的身体。 古往今来,靠坚强的信心使自己健康长寿的例子不胜枚举。寿臻百岁的马寅初认为:坚定的信仰,钢铁的意志,大海的胸怀,是一个人生命的基因。当     

高渗性非酮症糖尿病昏迷11例临床分析

高渗性非酮症糖尿病昏迷(HNDC)是糖尿病的急性代谢性并发症之一，是高血糖引起的高渗性脱水和进行性意识改变的临床综合征。随着糖尿病患病率的升高，该病发病率亦有增高趋势。现将我院从1995年～2000年收治的11例报道如下。 1 临床资料……     

癌症患者也可长命百岁

随着医学发展和社会的进步,癌症患者经治疗康复也可长命百岁。如马寅初创下了直肠癌康复后生存至100岁的奇迹;80岁高龄的抗癌明星老红军刘豪,胃癌康复42个春秋。山东省泰安市去年选出首届抗癌明星24人:其中康复30年以上2人;27年以上2人,15年以上6人;10年以上14人。 上述事例充分证明了癌症患者亦可长命百岁。美国临床肿瘤学会会长艾伦·利希特博士最近预言:“由于治癌诊断设备和治疗方法不断的改进。未来30年内癌症患者的死亡率可望减少一半。”事实证明很多癌症患者治疗     

心脏起搏器植入诱发急性痛风性关节炎临床分析

心脏起搏治疗已广泛应用于临床，虽然植入技术日趋成熟，但并发症难以避免，常见有囊袋血肿、导线脱位、囊袋感染、气胸等。笔者自2005年4月-2008年12月植入或更换永久性心脏起搏器56例，其中有5．36％（3／56）于术后出现植入起搏器侧上肢急性痛风性关节炎，现报道如下。     

我想活100岁

我今年75岁,从20岁起就从事新闻通讯工作,迄今已有55个春秋,拙作散见全国40多家报刊,约1000篇左右。我想活100岁的根基是: 一、《六十而立》的启示 某名家有一首《六十而立》诗:“长寿由已不由仙,六十而今才而立,踏遍青山人未老,枫丹日丽菊花天。”此诗以藐视千古的气魄,自信六十尚年轻的     

我的康复辞典

四自 自重.癌症患者在生死关头,如能举重若轻就可能使病情逆转.法国总统密特朗不因患前列腺癌而辞职,化险为夷,获康复,坚持总统五年任期满.     

以aVR导联为基础的新四步法对宽QRS心动过速的鉴别诊断价值

目的探讨以aVR导联为基础的Vereckei新四步法对宽QRS心动过速（WCT）的鉴别诊断价值。方法应用十二导联同步动态心电图,记录节律规整的WCT。根据出现室房分离、WCT时的QRS波形态与基础心律时的室性早搏完全相同,确认为室性心动过速（VT）,研究Vereckei新四步法流程图对WCT的诊断准确性。结果 Ve-reckei新四步法对VT诊断的敏感性为87.63%,特异性为92.53%,准确性为85.57%。结论以aVR导联为基础的Vereckei新四步法用于WCT的鉴别诊断,具有简单、准确的优点,有较高的临床价值。