经鼻高流量湿化对慢性阻塞性肺疾病急性加重期患者动脉血气指标水平影响

Effect of high nasal flow humidification on arterial blood gas index level in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨经鼻高流量湿化治疗在慢性阻塞性肺疾病中的应用效果,对于改善患者的临床症状具有重要意义。本研究分析经鼻高流量湿化对慢性阻塞性肺疾病急性加重期患者动脉血气指标水平影响。方法选择2017-01-01-2019-01-31鹤壁市人民医院收治的慢性阻塞性肺疾病患者为研究对象,均符合慢性阻塞性肺疾病诊断标准。按照组间性别、年龄、病程和急性加重时间等因素匹配的原则选择观察组和对照组,各96例。对照组采用常规持续鼻导管吸氧;观察组采用经鼻高流量湿化治疗。观察两组动脉血气分析变化情况,包括氧分压(oxygen partial pressure,PO2)、二氧化碳分压(partial pressure of carbon dioxide,PCO2)、血氧饱和度(blood oxygen saturation,SO2)及疗效。结果治疗前,观察组和对照组患者PO2水平分别为(57.59±2.16)和(57.79±2.45)mm Hg,差异无统计学意义,t=0.907,P=0.069;PCO2水平分别为(55.48±1.27)和(54.66±1.85)mm Hg,差异无统计学意义,t=1.389,P=0.059;SO2水平分别为(80.09±2.11)%和(80.79±2.46)%,差异无统计学意义,t=3.251,P=0.051。治疗后,观察组PO2水平为(83.69±3.48)mm Hg,高于对照组的(76.58±3.11)mm Hg,差异有统计学意义,t=20.018,P<0.001;PCO2水平为(53.64±2.28)mm Hg,低于对照组的(55.76±1.87)mm Hg,差异有统计学意义,t=9.110,P=0.012;SO2水平为(94.08±1.38)%,高于对照组的(91.18±1.3)%,差异有统计学意义,t=20.590,P<0.001。观察组治疗总有效率为89.58%,高于对照组的72.90%,差异有统计学意义,χ^2=5.341,P=0.026。结论经鼻高流量湿化治疗在慢性阻塞性肺疾病中的应用效果明显,可以改善患者的氧分压和血氧饱和度。

OBJECTIVE To explore the effect of transnasal high flow humidification in the treatment of chronic obstructive pulmonary disease(COPD)is of great significance to improve the clinical symptoms of patients.The purpose of this study is to analyze the effect of transnasal high flow humidification on arterial blood gas index in patients with acute exacerbation of COPD.METHODS Patients with COPD admitted to Hebi People’s Hospital from January 1,2017 to January 31,2019 were selected as the study objects,all of which met the diagnostic criteria of COPD.According to the matching principle of sex,age,course of disease,acute aggravation time and other factors among the groups,the observation group and the control group were selected in the study object,96 cases in each group.The control group was treated with conventional continuous nasal catheter,while the observation group was treated with transnasal high flow humidification.The changes of arterial blood gas analysis in the two groups were observed,including oxygen partial pressure(PO2),carbon dioxide partial pressure(PCO2),blood oxygen saturation(SO2)and curative effect.RESULTS Before treatment,the PO2 levels of the observation group and the control group were(57.59±2.16)and(57.79±2.45)mm Hg,respectively,with no significant difference(t=0.907,P=0.069);PCO2 levels were(55.48±1.27)and(54.66±1.85)mm Hg,respectively,the difference was not statistically significant(t=1.389,P=0.059);SO2 levels were(80.09±2.11)% and(80.79±2.46)%,respectively,the difference was not statistically significant(t=3.251,P=0.051).After treatment,the PO2 level of the observation group was(83.69±3.48)mm Hg,which was higher than that of the control group(76.58±3.11)mm Hg,with a statistically significant difference(t=20.018,P<0.001);the PCO2 level was(53.64±2.28)mm Hg,which was lower than that of the control group(55.76±1.87)mm Hg,with a statistically significant difference(t=9.110,P=0.012);the SO2 level was(94.08±1.38)%,which was higher than that of the control group(91.18±1.3)%,the difference was statistically significant(t=20.590,P<0.001).The total effective rate of the observation group was 89.58%,higher than 72.90%of the control group,the difference was statistically significant,χ2=5.341,P=0.026.CONCLUSION The application effect of transnasal high flow humidification in COPD is obvious,which can improve the oxygen partial pressure and blood oxygen saturation of patients.