经鼻高流量鼻导管湿化氧疗治疗中老年重症难治性肺炎合并呼吸衰竭的临床观察

Clinical observation on the treatment of middle-aged and elderly patients with severe refractory pneumonia complicated with respiratory failure by trans nasal high-flow nasal catheter humidifying oxygen therapy

目的观察经鼻高流量鼻导管湿化氧疗治疗中老年重症难治性肺炎合并呼吸衰竭的临床治疗效果。方法选取2018年3月~2020年3月我院收治的60例中老年重症难治性肺炎合并呼吸衰竭患者,将其随机分为常规组和试验组,常规组采用传统化痰、止咳、平喘、抗感染等治疗方式,试验组在常规组基础上采用经鼻高流量鼻导管湿化氧疗法,记录两组患者的动脉血气数据、血氧饱和度以及炎症指标变化,比较两组患者的肺炎和呼吸衰竭临床症状消失时间、呼吸困难情况以及日常生活质量。结果试验组患者的发绀、气短、肺部啰音三个临床症状的消失时间明显短于常规组,差异有统计学意义(P<0.05)。治疗前,常规组和试验组的Borg呼吸困难程度评分与SGRQ生活质量评分比较,差异无统计学意义(P>0.05);治疗后,试验组患者的Borg呼吸困难程度评分与SGRQ生活质量评分明显低于常规组,差异有统计学意义(P<0.05)。治疗后,试验组患者的炎症因子水平明显低于常规组,血气分析明显优于常规组,差异有统计学意义(P<0.05)。结论针对中老年重症肺炎合并呼吸衰竭患者采用经鼻高流量鼻导管湿化氧疗法,能够有效抑制炎症因子,改善呼吸困难症状,控制病情恶化,保持呼吸道湿润通畅,维护呼吸道正常功能,预防肺部感染,提高患者的生活质量,加速患者预后。

Objective To observe the clinical therapeutic efficacy of trans nasal high-flow nasal catheter humidifying oxygen therapy on middle-aged and elderly patients with severe refractory pneumonia complicated with respiratory failure.Methods A total of 60 middle-aged and elderly patients with severe refractory pneumonia complicated with respiratory failure admitted to our hospital from March 2018 to March 2020 were selected and randomly divided into the conventional group and the experimental group.The conventional group was treated with traditional therapeutic method of resolving phlegm,relieving cough,relieving asthma and anti-infection,while the experimental group was treated with trans nasal high-flow nasal catheter humidifying oxygen therapy on the basis of the conventional group.The arterial blood gas(ABG)data,oxygen saturation and inflammation index changes of the two groups of patients were recorded,and the disappearance time of clinical symptoms of pneumonia and respiratory failure,dyspnea and quality of daily life were compared between the two groups.Results The disappearance time of cyanosis,dyspnea and pulmonary rales in the experimental group was significantly shorter than that in the conventional group,with statistically significant differences(P<0.05).Before treatment,there were no significant differences between Borg dyspnea score and SGRQ quality of life score between the conventional group and the experimental group(P>0.05).After treatment,Borg dyspnea score and SGRQ quality of life score in the experimental group were significantly lower than those in the conventional group,with statistically significant differences(P<0.05).After treatment,the inflammatory factors in the experimental group were significantly lower than those in the conventional group,and the ABG analysis in the experimental group was significantly superior than that in the conventional group,with statistically significant differences(P<0.05).Conclusion For middle-aged and elderly patients with severe pneumonia complicated with respiratory failure,trans nasal high-flow nasal catheter humidifying oxygen therapy can effectively inhibit inflammatory factors,improve dyspnea symptoms,effectively control the deterioration of the disease,keep the respiratory tract moist,maintain the normal function of respiratory tract,prevent pulmonary infection,improve the quality of life and accelerate the prognosis of patients.