经鼻高流量呼吸湿化氧疗对脑卒中相关肺炎患者的效果及对血清炎性因子TNF-α的影响观察

Observation on the effect of humidified high-flow nasal cannula on patients with stroke-related pneumonia and its influence on serum inflammatory factor TNF-α

目的探究经鼻高流量呼吸湿化氧疗对脑卒中相关肺炎患者的效果及对血清炎性因子肿瘤坏死因子-α(TNF-α)的影响。方法 70例脑卒中相关肺炎患者,采用数字随机分组法分为对照组和观察组,各35例。对照组患者均实施常规吸氧治疗,观察组患者给予经鼻高流量呼吸湿化氧疗。比较两组患者治疗前后血清炎性因子TNF-α、降钙素原水平,气管插管发生率和病死率,重症加强护理病房(ICU)住院时间,临床疗效。结果治疗6 d后,两组患者TNF-α、降钙素原水平均低于治疗前,且观察组患者TNF-α(26.07±2.84)ng/L、降钙素原(0.49±0.08)ng/ml均低于对照组的(30.55±3.37)ng/L、(1.15±0.37)ng/ml,差异均具有统计学意义(P<0.05)。观察组气管插管率11.43%、死亡率0均低于对照组的34.29%、11.43%,差异均具有统计学意义(P<0.05)。观察组患者的ICU住院时间(7.19±2.06)d短于对照组的(11.96±2.49)d,差异具有统计学意义(P<0.05)。观察组治疗总有效率94.29%高于对照组的74.29%,差异具有统计学意义(P<0.05)。结论经鼻高流量呼吸湿化氧疗对脑卒中相关肺炎患者的临床疗效可观,且有利于控制血清炎性因子TNF-α水平,在预后改善以及缩短ICU住院治疗时间方面有重要意义,值得进一步推广于今后临床中。

Objective To investigate the effect of humidified high-flow nasal cannula on patients with stroke-related pneumonia and its influence on serum inflammatory factor tumor necrosis factor-α(TNF-α). Methods A total of 70 patients with stroke-related pneumonia were divided into control group and observation group according to random numerical table, with 35 cases in each group. The control group received conventional oxygen inhalation therapy, and the observation group received humidified high-flow nasal cannula. The serum inflammatory factors TNF-α and procalcitonin before and after treatment, incidence and mortality of tracheal intubation, hospitalization time in intensive care unit(ICU) and the clinical efficacy were compared between the two groups. Results 6 d after treatment, TNF-α and procalcitonin of the two groups were lower than those before treatment, and TNF-α(26.07±2.84) ng/L and procalcitonin(0.49±0.08) ng/ml of the observation group were lower than(30.55±3.37) ng/L and(1.15±0.37) ng/ml of the control group, and the difference was statistically significant(P<0.05). The incidence and mortality of tracheal intubation of the observation group were 11.43% and 0, which were lower than 34.29% and 11.43% of the control group, and the difference was statistically significant(P<0.05). The hospitalization time in ICU of the observation group was(7.19±2.06) d, which was shorter than(11.96±2.49) d of the control group, and the difference was statistically significant(P<0.05). The total treatment effective rate of the observation group was 94.29%, which was higher than 74.29% of the control group, and the difference was statistically significant(P<0.05). Conclusion Humidified high-flow nasal cannula has considerable clinical efficacy in patients with stroke-related pneumonia, and is beneficial to control the serum inflammatory factor TNF-α level. It is of great significance in improving the prognosis and shortening hospitalization time in ICU. It is worthy of further promotion in the future.