无创机械通气不同吸入氧浓度对老年COPD合并呼吸衰竭患者血氧指标、呼吸状况的影响

Effect of different inhaled oxygen concentration on blood oxygenation and respiratory status in elderly COPD patients with respiratory failure after non-invasivemechanical ventilation

目的:探讨无创机械通气吸入氧浓度对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者血氧指标、呼吸状况的影响。方法:选取2017年1月至2019年4月清远市清新区人民医院收治的148例老年COPD合并呼吸衰竭患者作为研究对象,按吸入氧浓度分为45%组(n=74)、60%组(n=74)。比较两组治疗前后血氧指标[二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)、动脉血氧分压(PaO2)]、呼吸状况[呼吸道阻力、第一秒最大呼气量(FEV1)、FEV1预计值百分比(FEV1%)]、并发症发生率。结果:治疗5 d后,45%组PaO2/FiO2、PaO2、FEV1、FEV1%高于60%组(P<0.05),呼吸道阻力、PaCO2低于60%组(P<005);45%组并发症发生率为1.35%(1/74),与60%组的5.41%(4/74)比较,差异无统计学意义(P>0.05)。结论:45%吸入氧浓度能显著改善老年COPD合并呼吸衰竭患者血氧指标和呼吸状况,安全性更高。

Objective:To investigate the effects of non-invasive mechanical ventilation using different concentrations of inhaled oxygen on blood oxygenation and breathing in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 148 patients with COPD and respiratory failure in Qingxin District People’s Hospital between January 2017 and April 2019 were enrolled,and according to the level of inhaled oxygen,divided into 45%oxygen group(n=74)and 60%oxygen group(n=74).The two groups were compared for blood oxygenation[CO2 partial pressure(PaCO2),oxygenation index(PaO2/FiO2),arterial partial pressure of oxygen(PaO2)],respiratory status[respiratory resistance,forced expiratory volume in one second(FEV1),percentage of predicted FEV1(FEV1%)]at baseline and after treatment,as well as the rate of complications.Results:At 5 days of treatment,patients in the 45%oxygen group FiO2,PaO2,FEV1,and FEV1%,lower respiratory resistance and PaCO2,compared with those in the 60%oxygen group(P<0.05).The rate of complications was 1.35%(1/74)in the 45%oxygen group,which was comparable with 5.41%(4/74)as found in the 60%oxygen group,with no statistically significant difference(P>0.05).Conclusion:Inhalation of 45%oxygen may significantly improve the blood oxygenation and breathing in elderly patients with COPD and respiratory failure,and meanwhile with better safety.