沙美特罗替卡松联合有创机械通气-经鼻高流量氧疗序贯疗法治疗慢阻肺伴呼吸衰竭的效果及对氧代谢、炎性因子水平的影响

Effect of salmeterol xinafoate and fluticasone propionate combined with invasive mechanical ventilation-nasal high flow oxygen therapy sequential therapy on chronic obstructive pulmonary disease with respiratory failure and its influences on oxygen metabolism and inflammatory factor levels

目的分析沙美特罗替卡松联合有创机械通气-经鼻高流量氧疗序贯疗法治疗慢阻肺伴呼吸衰竭的效果。方法择取2019年2月至2021年3月收治的120例慢阻肺伴呼吸衰竭患者为研究对象,将其随机分为对照组和观察组,各60例。对照组采用有创机械通气-经鼻高流量氧疗序贯疗法,观察组在对照组基础上加用沙美特罗替卡松治疗。比较两组的治疗效果。结果观察组的治疗总有效率显著高于对照组(P<0.05)。治疗后,观察组的最大摄氧量(VO_(2max))、氧摄取率(O_(2)ER)、动脉血二氧化碳分压(PaCO_(2))低于对照组,动脉血氧含量(CaO_(2))高于对照组(P<0.05)。治疗后,观察组的白细胞介素-18(IL-18)、降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。结论沙美特罗替卡松联合有创机械通气-经鼻高流量氧疗序贯疗法治疗慢阻肺伴呼吸衰竭患者,不仅能够提升临床治疗效果,还能改善氧代谢、抑制炎性反应,对肺功能恢复具有积极作用,值得推广。

Objective To analyze the effect of salmeterol xinafoate and fluticasone propionate combined with invasive mechanical ventilation-nasal high flow oxygen therapy sequential therapy on chronic obstructive pulmonary disease with respiratory failure.Methods A total of 120 patients with chronic obstructive pulmonary disease with respiratory failure admitted from February 2019 to March 2021 were selected as the research objects and randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with invasive mechanical ventilation-nasal high flow oxygen therapy sequential therapy,and the observation group was treated with salmeterol xinafoate and fluticasone propionate on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the maximal oxygen consumption(VO_(2max)),oxygen extraction ratio(O_(2)ER)and arterial partial pressure of carbon dioxide(PaCO_(2))in the observation group were lower than those in the control group,and the arterial oxygen content(CaO_(2))was higher than that in the control group(P<0.05).After treatment,the levels of interleukin-18(IL-18),procalcitonin(PCT),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).Conclusion Salmeterol xinafoate and fluticasone propionate combined with invasive mechanical ventilation-nasal high flow oxygen therapy sequential therapy in the treatment of patients with chronic obstructive pulmonary disease with respiratory failure can not only improve the clinical treatment effect,but also improve oxygen metabolism,inhibit inflammatory response.It has a positive effect on the recovery of lung function and is worthy of promotion.