经鼻高流量湿化氧疗在慢性阻塞性肺疾病急性加重期患者中的应用效果

Application effect of transnasal high flow humidification oxygen therapy in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨经鼻高流量湿化氧疗(HHFNC)在慢性阻塞性肺疾病(COPD)急性加重期患者中的应用效果。方法选取2017年10月~2018年10月我院呼吸科收治的85例COPD急性加重期患者作为研究对象,采用随机数字表法将其分为参照组(n=42)和研究组(n=43)。参照组患者采用无创正压通气进行呼吸支持,研究组患者采用HHFNC进行呼吸支持。比较两组患者治疗后的呼吸频率(R)、动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、氧合指数(OI)的变化情况,统计两组患者的气管插管机械通气率、治疗依从性以及并发症发生情况。结果两组患者治疗后的R、PaCO2均低于治疗前,PaO2、OI高于治疗前,差异有统计学意义(P<0.05);两组患者治疗后的R、PaO2、PaCO2、OI比较,差异无统计学意义(P>0.05);两组患者的气管插管机械通气率比较,差异无统计学意义(P>0.05);研究组患者的治疗依从性高于参照组,并发症总发生率低于参照组,差异均有统计学意义(P<0.05)。结论COPD急性加重期患者采用HHFNC的方式进行呼吸支持治疗,能够有效改善患者的通气功能,且患者的依从性好,并发症少,具有推广应用价值。

Objective To investigate the application effect of transnasal high flow humidification oxygen therapy(HHFNC)in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods From October 2017 to October 2018,85 patients with acute exacerbation of COPD treated in respiratory department of our hospital were selected as the subjects of study.They were divided into control group(n=42)and study group(n=43)by the random number table method.The patients in the control group were treated with noninvasive positive pressure ventilation for respiratory support,while the study group was treated with HHFNC for respiratory support.The changes of respiratory frequency(R),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)and oxygen index(OI)after treatment were compared between the two groups.The rate of mechanical ventilation of tracheal intubation,treatment compliance and treatment complications were counted.Results The R and PaCO2 of the two groups after treatment were lower than those before treatment,PaO2 and OI were higher than those before treatment,the differences were statistically significant(P<0.05).There were no significant differences in R,PaCO2,PaCO2 and OI between the two groups after treatment(P>0.05).There was no significant difference in the rate of mechanical ventilation of tracheal intubation between the two groups(P>0.05).The treatment compliance of the study group was higher than that of the control group,and the total incidence of complications was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion Respiratory support therapy with HHFNC in patients with acute exacerbation of COPD can effectively improve the ventilation function of patients,and the compliance of patients is good and the complications are few,so it is valuable to popularize and apply.