经鼻高流量氧疗在I型呼吸衰竭和二氧化碳潴留不明显的Ⅱ型呼吸衰竭中的疗效

Efficacy of intranasal high flow oxygen therapy for typeⅠrespiratory failure and typeⅡrespiratory failure with no obvious carbon dioxide retention

目的观察经鼻高流量氧疗在Ⅰ型呼吸衰竭(简称“呼衰”)和二氧化碳潴留不明显的Ⅱ型呼衰中的临床效果。方法选取2019年7月—2020年3月于江苏省常熟市第二人民医院呼吸科就诊收治的60例Ⅰ型呼衰和二氧化碳潴留不明显的Ⅱ型呼衰患者为研究对象,根据数字奇偶法分为对照组和观察组,每组30例。对照组采用无创正压通气治疗,观察组采用经鼻高流量氧疗。比较两组治疗总有效率,记录治疗前后血气分析指标、血流动力学指标、舒适度评分及Borg评分,并观察两组治疗期间不良事件发生率。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后两组血氧饱和度(SpO2)及氧分压(SaO2)水平明显高于治疗前,二氧化碳分压(PaCO2)低于治疗前,且治疗后观察组PaO2及SaO2水平高于对照组,PaCO2水平低于对照组,差异有统计学意义(P<0.05);治疗后两组心率(HR)、呼吸频率(RR)及肺动脉压(PAP)均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后两组舒适度评分高于治疗前,Borg评分低于治疗前,且观察组舒适度评分高于对照组,Borg评分低于对照组,差异有统计学意义(P<0.05);观察组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论经鼻高流量氧疗可明显改善Ⅰ型呼衰和二氧化碳潴留不明显的Ⅱ型呼衰患者的临床症状和氧和状态,并提高舒适度,减少不良事件发生。

Objective To observe the curative effect of intranasal high flow oxygen therapy for typeⅠfailure andⅡrespiratory failure with no obvious carbon dioxide retention.Methods A total of 60 patients with typeⅠfailure andⅡrespiratory failure with no obvious carbon dioxide retention were selected as the research subjects from July 2019 to March 2020 in the Department of Respiratory Medicine of the Changshu NO.2 People’s Hospital,Jiangsu Province,according to numerical odd-even method,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with non-invasive positive pressure ventilation,and the observation group was treated with transnasal high-flow oxygen therapy.The effective rate of treatment was compared between the two groups,blood gas analysis indexes,hemodynamic indexes,comfort score and Borg score were recorded before and after treatment,and the incidence of adverse events during treatment was observed between the two groups.Results The total effective rate of observation group was higher than control group,and the difference was statistically significant(P<0.05).After treatment,the levels of oxygen saturation(SpO2)and oxygen partial pressure(SaO2)in the two groups were significantly higher than before treatment,the level of carbon dioxide partial pressure(PaCO2)was lower than before treatment,and after treatment,the levels of PaO2 and SaO2 in the observation group were higher than the control group,while the levels of PaCO2 was lower than the control group,with statistical significance(P<0.05).After treatment,heart rate(HR),respiratory rate(RR)and pulmonary artery pressure(PAP)in the two groups were lower than before theatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the comfort scores of the two groups were higher than before treatment,the Borg scores were lower than before treatment,and the comfort score of the observation group was higher than the control group,and the Borg score was lower than the control group,and the differences were statistically significant(P<0.05).The incidence of adverse events in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Transnasal high-flow oxygen therapy can significantly improve the clinical symptoms and oxygen status for typeⅠfailure andⅡrespiratory failure with no obvious carbon dioxide retention,and improve the comfort level and reduce the occurrence of adverse events.