经鼻高流量氧疗与无创正压通气联合治疗慢性阻塞性肺疾病急性加重期患者的效果

Clinical application of high-flow nasal cannula oxygen and noninvasive positive pressure ventilation in acute exacerbation of chronic obstructive pulmonary disease

目的:对比经鼻高流量氧疗(HFNC)与无创正压通气联合与单用无创正压通气(NPPV)在治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效,初步探讨其在治疗AECOPD的临床可行性。方法:回顾性分析80例中度(Ⅱ级)AECOPD患者,其中HFNC联合NPPV治疗40例(观察组),NPPV治疗组40例(对照组),比较治疗前后pH、PO2、PCO2等指标及2组治疗转归。结果:2组治疗后动脉血气中pH、PO2、PCO2均有改善,但2组之间无显著性差异。观察组患者表现出更好的耐受性,差异有统计学意义(P<0.05)。2组插管及住院时间无明显差异。结论:HFNC与NPPV联合治疗中度Ⅱ级AECOPD与NPPV具有相当的治疗效果,且患者耐受性更好,可供临床借鉴。

Objective:To compare the efficacy of high flow oxygen inhalation(HFNC)and non-invasive positive pressure ventilation(NPPV)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to preliminarily study its clinical feasibility in the treatment of AECOPD.Methods:Eighty patients with moderate(gradeⅡ)AECOPD were analyzed retrospectively,including HFNC plus NPPV group(n=40)and NPPV group(n=40).The pH,PO 2 and PCO 2 before and after treatment were compared and the treatment outcomes of the two groups were compared.Results:pH,PO 2 and PCO 2 in arterial blood gas were improved in both groups after treatment,but there was no significant difference between the two groups,and the combined treatment group showed better tolerance.There was no significant difference in intubation and hospital stay between the two groups.Conclusions:The treatment of moderate AECOPD(Ⅱ)by HFNC and NPPV combition has the same therapeutic effects as NPPV and better tolerance,which can be used for clinical pratices.