无创正压通气与经鼻高流量湿化氧疗治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的疗效对比

Comparison of the Efficacy of Noninvasive Positive Pressure Ventilation and High-Flow Nasal Cannula Oxygen Therapy in Patients with Chronic Obstructive Pulmonary Disease Complicated with TypeⅡRespiratory Failure

目的探讨经鼻高流量湿化氧疗(HFNC)与无创正压通气(NPPV)在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者中的应用价值.方法选择2020年1月—2021年1月我院收治的COPD合并Ⅱ型呼吸衰竭患者78例为研究对象,按随机数字表法分为两组,每组39例.两组均接受常规对症治疗,在此基础上,对照组采用NPPV治疗,研究组则采用HFNC治疗.对比两组的各项血气分析指标、呼吸频率、心率、舒适度及并发症发生情况.结果治疗后,两组的动脉血氧分压(PaO_(2))、酸碱度(pH)均高于治疗前,动脉血二氧化碳分压(PaCO_(2))、呼吸频率、心率均低于治疗前,差异有统计学意义(P<0.05);但两组间PaO_(2)、PaCO_(2)、pH值、呼吸频率、心率比较,差异无统计学意义(P>0.05).研究组的舒适度优于对照组,差异有统计学意义(P<0.05).研究组的并发症发生率为5.13%,低于对照组的20.51%,差异有统计学意义(P<0.05).结论HFNC与NPPV在缓解COPD合并Ⅱ型呼吸衰竭患者机体缺氧症状、改善血气指标方面均能够取得较佳的效果,但相比于NPPV,HFNC能够减轻患者痛苦,减少并发症的发生,具有更高的应用价值.

Objective To investigate the clinical value of high-flow nasal cannula oxygen therapy(HFNC)and noninvasive positive pressure ventilation(NPPV)in patients with chronic obstructive pulmonary disease(COPD)complicated with typeⅡrespiratory failure.Methods 78 patients with COPD complicated with typeⅡrespiratory failure admitted to our hospital from January 2020 to January 2021 were selected as the study objects,and were divided into two groups according to random number table method,with 39 cases in each group.Both groups received conventional symptomatic treatment.On this basis,the control group was treated with NPPV,and the study group was treated with HFNC.The blood gas analysis indexes,respiratory rate,heart rate,comfort level and complications of the two groups were compared.Results After treatment,the arterial partial pressure of oxygen(PaO_(2))and pH were higher than before treatment,arterial partial pressure of carbon dioxide(Pa-CO2),respiratory rate and heart rate were lower than before treatment,the differences were statistically significant(P<0.05);however,there were no significant differences in PaO_(2),PaCO_(2),pH,respiratory rate and heart rate between the two groups(P>0.05).The comfort level of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).The complication rate of the study group was 5.13%,lower than 20.51%of the control group,and the difference was statistically significant(P<0.05).Conclusion HFNC and NPPV can achieve better results in alleviating hypoxia symptoms and improving blood gas indicators in patients with COPD combined with typeⅡrespiratory failure.However,compared with NPPV,HFNC can relieve patients'pain and reduce the occurrence of complications,and has higher application value.