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经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效及近期预后的影响
引用本文:柴书坤,王震,王小琳,史金英,李艳肖,王正.经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效及近期预后的影响[J].河北医科大学学报,2020,41(7):764.
作者姓名:柴书坤  王震  王小琳  史金英  李艳肖  王正
作者单位:1.河北省石家庄市第一医院呼吸内三科,河北 石家庄 050011;2.河北医科大学第二医院呼吸三科,河北 石家庄 050000
基金项目:石家庄市科学技术研究与发展指导计划
摘    要:的 探讨经鼻高流量吸氧对慢性阻塞性肺疾病急性加重期(acute exacerbation chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者的疗效及近期预后的影响。 方法 选择66例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象,简单随机数字表法分为研究组和对照组,每组33例。两组患者均接受基础综合治疗,对照组患者行无创正压通气治疗,研究组患者行经鼻高流量吸氧治疗。比较两组患者治疗前后的血气指标、生命体征指标变化情况、临床疗效、近期预后情况。 结果 治疗后,两组pH值、动脉血氧分压(partial pressure of oxygen,PaO2)、氧合指数(oxygenation index,PaO2/FiO2)均高于治疗前,且研究组pH值、PaO2、PaO2/FiO2高于对照组,而两组呼吸频率(respiratory rate,RR)、心率(heart rate,HR)均低于治疗前,且研究组RR、HR低于对照组,差异有统计学意义(P<0.05)。研究组患者的临床疗效总有效率为96.97%,显著高于对照组患者的81.82%,差异有统计学意义(P<0.05)。两组患者的28 d气管插管率、90 d病死率比较,差异无统计学意义(P>0.05),而研究组患者的好转率为84.85%,高于对照组患者的63.64%,差异有统计学意义(P<0.05)。 结论 经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效显著,近期预后满意,值得临床应用。

关 键 词:肺疾病  慢性阻塞性  呼吸功能不全  经鼻高流量吸氧  

Effect of high-flow nasal cannula oxygen therapy on the efficacy and short-term prognosis of transnasal high flow oxygen inhalation AECOPD patients with type Ⅱ respiratory failure
CHAI Shu-kun,WANG Zhen,WANG Xiao-lin,SHI Jin-ying,LI Yan-xiao,WANG Zheng.Effect of high-flow nasal cannula oxygen therapy on the efficacy and short-term prognosis of transnasal high flow oxygen inhalation AECOPD patients with type Ⅱ respiratory failure[J].Journal of Hebei Medical University,2020,41(7):764.
Authors:CHAI Shu-kun  WANG Zhen  WANG Xiao-lin  SHI Jin-ying  LI Yan-xiao  WANG Zheng
Institution:1.TheThird Department of Respiratory Medicine, the First Hospital of Shijiazhuang City, Hebei
Province, Shijiazhuang 050011, China; 2.The Third Department of Respiratory Medicine,
the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
Abstract:Objective〖HTSS〗To explore the effect of high flow oxygen inhalation through nose on the efficacy and short-term prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD, AECOPD) and type II respiratory failure. 〖WTHZ〗Methods〖HTSS〗Sixty-six patients with AECOPD combined with type Ⅱ respiratory failure were selected as the research object. The simple random number table method was divided into a research group and a control group, 33 cases in each group.Patients in both groups received basic comprehensive treatment, patients in the control group received noninvasive positive pressure ventilation, and patients in the study group received nasal high-flow oxygen therapy.The changes of blood gas indexes and vital signs indexes before and after treatment were compared between two groups of patients, as well as clinical efficacy and short-term prognosis. 〖WTHZ〗Results〖HTSS〗After treatment, the pH, arterial partial pressure of oxygen(PaO2 supplement), and oxygenation index(PaO2/FiO2) of the two groups of patients were higher than before treatment, and the patients in the study group were higher than those in the control group. The respiratory rate(RR) and heart rate(HR) of the two groups of patients were lower than before treatment, and the patients in the study group were lower than those in the control group, the difference was statistically significant(P<0.05). The total effective rate of clinical efficacy in the study group was 96.97%, which was much better than 81.82% in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in 28 day tracheal intubation rate and 90 day mortality rate between two groups(P>0.05), while the improvement rate of the study group was 84.85%, which was higher than that of the control group, 63.64%. Statistical significance(P<0.05). 〖WTHZ〗Conclusion〖HTSS〗The effect of transnasal high flow oxygen inhalation on AECOPD patients with type Ⅱ respiratory failure is significant, and the short-term prognosis is satisfactory, which is worthy of clinical application.
Keywords:pulmonary disease  chronic obstructive  respiratory insufficiency  Transnasal hyperflow oxygen inhalation  
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