经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效及近期预后的影响

Effect of high-flow nasal cannula oxygen therapy on the efficacy and short-term prognosis of transnasal high flow oxygen inhalation AECOPD patients with typeⅡrespiratory failure

目的探讨经鼻高流量吸氧对慢性阻塞性肺疾病急性加重期(acute exacerbation chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者的疗效及近期预后的影响。方法选择66例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象,简单随机数字表法分为研究组和对照组,每组33例。两组患者均接受基础综合治疗,对照组患者行无创正压通气治疗,研究组患者行经鼻高流量吸氧治疗。比较两组患者治疗前后的血气指标、生命体征指标变化情况、临床疗效、近期预后情况。结果治疗后,两组pH值、动脉血氧分压(partial pressure of oxygen,PaO2)、氧合指数(oxygenation index,PaO2/FiO2)均高于治疗前,且研究组pH值、PaO2、PaO2/FiO2高于对照组,而两组呼吸频率(respiratory rate,RR)、心率(heart rate,HR)均低于治疗前,且研究组RR、HR低于对照组,差异有统计学意义(P<0.05)。研究组患者的临床疗效总有效率为96.97%,显著高于对照组患者的81.82%,差异有统计学意义(P<0.05)。两组患者的28 d气管插管率、90 d病死率比较,差异无统计学意义(P>0.05),而研究组患者的好转率为84.85%,高于对照组患者的63.64%,差异有统计学意义(P<0.05)。结论经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效显著,近期预后满意,值得临床应用。

Objective To explore the effect of high flow oxygen inhalation through nose on the efficacy and short-term prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD,AECOPD)and type II respiratory failure.Methods Sixty-six patients with AECOPD combined with typeⅡrespiratory failure were selected as the research object.The simple random number table method was divided into a research group and a control group,33 cases in each group.Patients in both groups received basic comprehensive treatment,patients in the control group received noninvasive positive pressure ventilation,and patients in the study group received nasal high-flow oxygen therapy.The changes of blood gas indexes and vital signs indexes before and after treatment were compared between two groups of patients,as well as clinical efficacy and short-term prognosis.Results After treatment,the pH,arterial partial pressure of oxygen(PaO2 supplement),and oxygenation index(PaO2/FiO2)of the two groups of patients were higher than before treatment,and the patients in the study group were higher than those in the control group.The respiratory rate(RR)and heart rate(HR)of the two groups of patients were lower than before treatment,and the patients in the study group were lower than those in the control group,the difference was statistically significant(P<0.05).The total effective rate of clinical efficacy in the study group was 96.97%,which was much better than 81.82%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in 28 day tracheal intubation rate and 90 day mortality rate between two groups(P>0.05),while the improvement rate of the study group was 84.85%,which was higher than that of the control group,63.64%.Statistical significance(P<0.05).Conclusion The effect of transnasal high flow oxygen inhalation on AECOPD patients with typeⅡrespiratory failure is significant,and the short-term prognosis is satisfactory,which is worthy of clinical application.