经鼻高流量氧疗治疗老年重症肺炎的临床疗效和安全性研究

Study on the clinical efficacy and safety of transnasal high-flow oxygen therapy in the treatment of senile patient with severe pneumonia

目的:研究经鼻高流量氧疗治疗老年重症肺炎的临床疗效和安全性。方法:选取在医院就诊的90例重症肺炎老年患者,按照数表法随机将其分为对照组和观察组,每组45例。对照组采用无创机械通气治疗方法,观察组采用经鼻高流量氧疗治疗方法,观察并比较两组临床疗效、痰液粘稠度、血气分析及并发症情况。结果:观察组临床治疗总有效率为80.00%,显著高于对照组的60.00%,其差异有统计学意义(x^2=4.286,P<0.05);治疗后7 d观察组和对照组痰液粘稠度Ⅱ级人数显著增加,Ⅲ级、Ⅳ级人数显著减少,两组患者痰液粘稠度分级比较差异有统计学意义(Z=6.547,P<0.05);两组患者治疗后的血气分析比较中观察组呼吸频率(RR)、二氧化碳分压(PCO2)值与治疗前相比显著降低,差异有统计学意义(t=5.331,t=2.283;P<0.05);两组氢离子浓度(pH)值及氧合指数(OI)值治疗前后无明显改变;治疗后观察组氧分压(PO2)值显著高于治疗前,差异有统计学意义(t=2.325,P<0.05)。观察组术后并发症发生率为17.78%,对照组为22.22%,两组比较差异无统计学意义。结论:老年重症肺炎经鼻高流量氧疗治疗后临床疗效显著,呼吸困难症状明显缓解,且并发症发生率较低,安全性较高。

Objective:To study the clinical efficacy and safety of transnasal high-flow oxygen therapy in the treatment of senile patient with severe pneumonia.Methods:Ninety senile patients with severe pneumonia admitted to hospital were selected as study subjects,and they were randomly divided into observation group(45 cases)and control group(45 cases)according to the random number table.Patients of control group were treated with the method of noninvasive mechanical ventilation.Patients of observation group were treated with the method of transnasal high-flow oxygen.The differences of clinical efficacy,sputum viscosity,blood gas analysis and complications between the two groups were observed and compared.Results:The total effective rate of clinical therapy of observation group was 80.00%,which was significantly higher than that of control group(60.00%)(x^2=4.286,P<0.05).The number of people with sputum viscosity gradeⅡof observation group and control group significantly increased at 7th d post treatment,and that with sputum viscosity gradeⅢandⅣof two groups significantly decreased at the same time,and the differences of sputum viscosity grading between two groups were significantly(Z=6.547,P<0.05).In the analysis and comparison of blood gas analysis of two groups post treatment,the respiratory rate(RR)and partial pressure of CO2 of observation group after treatment were significantly decreased than that before treatment(t=5.331,t=2.283,P<0.05),respectively.There were not significant changes in the values of pH and OI of two groups between before and after treatment.The PO2 values of observation group after treatment was significantly higher than that before treatment(t=2.325,P<0.05).The total incidence rate of postoperative complications of observation group was 17.78%and that of control group was 22.22%,and the difference of that between two groups was not statistically significant.Conclusion:After senile patients with severe pneumonia receive the treatment of transnasal high-flow oxygen therapy,the clinical efficacy of this therapy is significant.And the dyspnea symptoms of them are significantly relieved,and the incidence rate of complication is lower,and the safety of this therapy is higher.