高流量氧疗对慢性阻塞性肺疾病急性加重期合并中度Ⅱ型呼吸衰竭的治疗效果

Effect of high flow oxygen therapy on acute exacerbation of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

目的 探讨高流量氧疗(HFNC)对慢性阻塞性肺疾病病急性加重期(AECOPD)合并中度Ⅱ型呼吸衰竭的治疗效果。方法 以87例AECOPD合并中度Ⅱ型呼吸衰竭患者作为研究对象,其中使用HFNC治疗的44例作为HFNC组,使用无创通气(NIV)治疗的43例作为对照组;比较2组患者治疗前、治疗24、48、72 h时的动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、呼吸频率(RR)、心率(HR)、平均动脉压(MAP)及患者依从性。结果 2组患者治疗24、48及72 h时的Pa O2较治疗前升高、Pa CO2、RR、HR、MAP及患者依从性均较治疗前降低,差异有统计学意义(P<0.05);2组患者治疗24、48及72 h时的Pa O2、Pa CO2、RR、HR、MAP比较,差异无统计学意义(P>0.05);HFNC组患者治疗24和48 h时的依从性好的患者人数多于NIV组,但差异无统计学意义(P>0.05);HFNC组患者治疗72 h时依从性好的患者人数多于NIV组,差异有统计学意义(P<0.05)。结论 HFNC对AECOPD合并中度Ⅱ型呼吸衰竭的患者疗效与NIV相当,但患者依从性较好。

Objective To investigate the effect of high flow nasal cannula oxygen therapy(HFNC) on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with moderate type Ⅱ respiratory failure.Methods 87 cases of AECOPD with type Ⅱ respiratory failure(moderate) were analyzed as research objects retrospectively.44 cases were treated with HFNC and 43 cases were treated with noninvasive ventilation(NIV) as control group.Before the treatment and at 24,48,and72 h during the treatment,PaO2,PaCO2,RR,HR,MAP,and the compliance of 2 groups were compared.Results The PaO2 levels in the two groups at 24,48,and 72 h during the treatment were higher than those before treatment.After treatment,PaCO2,RR,HR,MAP,and compliance of all patients were lower than those before treatment,and the differences were statistically significant(P<0.05);there were no statistically significant differences in PaO2,PaCO2,RR,HR,and MAP between two groups at 24,48,and 72 h during treatment(P>0.05).The number of patients with good compliance was higher than that of the NIV group at 24 and 48 h during treatment,the difference was not statistically significant(P>0.05);the number of patients with good compliance was higher than that of the NIV group at 72 h during treatment,the difference was statistically significant(P<0.05).Conclusion The therapeutic effect of HFNC on AECOPD patients with moderate type Ⅱ respiratory failure is similar to that of NIV and the compliance is better than that of NIV.HFNC can be used for AECOPD patients with moderate type Ⅱ respiratory failure who cannot tolerate NIV.