经鼻高流量氧疗治疗肺结核合并Ⅰ型呼吸衰竭的探讨与护理研究

Discussion and Nursing Research on the Treatment of Pulmonary Tuberculosis with TypeⅠRespiratory Failure by Nasal High Flow Oxygen

目的探讨肺结核合并Ⅰ型呼吸衰竭患者使用经鼻高流量氧疗并进行护理配合的临床效果。方法方便选取2018年8月—2020年4月于该院进行治疗的肺结核合并Ⅰ型呼吸衰竭患者60例,根据纳入与排除标准开展临床研究,将其按照护理方法分为对照组和研究组,每组30例。两组患者行常规抗结核、抗感染、对症支持治疗以及呼吸湿化治疗仪吸氧,对照组接受常规护理,研究组接受精细化护理,对比两组患者护理前及护理治疗后7 d动脉血氧分压(PaO_(2))、动脉血氧二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))、心率及呼吸频率指标变化情况。结果两组患者治疗后PaO_(2)、PaCO_(2)及SaO_(2)指标均得到改善,其中研究组治疗后PaO_(2)、PaCO_(2)及SaO_(2)指标显著优于对照组,差异有统计学意义(P<0.05);研究组患者治疗后心率(HR)指标(86.58±10.21)、呼吸频率(RR)指标(22.76±5.41)次/min显著低于对照组,差异有统计学意义(t=2.683、6.553,P<0.05)。结论经鼻高流量氧疗替代鼻导管吸氧,并结合其他常规治疗方法,配合精细化护理对肺结核合并Ⅰ型呼吸衰竭的治疗效果较好,值得临床进一步应用推广。

Objective To investigate the clinical effect of pulmonary tuberculosis patients with typeⅠrespiratory failure using high-flow nasal oxygen therapy and nursing cooperation.Methods Conveniently selected patients with pulmonary tuberculosis and type I respiratory failure who were treated in the hospital from August 2018 to April 2020.According to the inclusion and exclusion criteria,60 cases were selected for clinical research,and they were divided into control group and study group according to nursing methods,30 cases in each group.The two groups of patients received routine anti-tuberculosis,anti-infection,symptomatic supportive treatment,and oxygen inhalation with a respiratory humidification treatment device.The control group received routine nursing care,and the study group received refined nursing care.The changes of PaO_(2),PaCO_(2),SaO_(2),heart rate and respiratory frequency index before study and 7 d after study were compared between the two groups.Results The PaO_(2),PaCO_(2),and SaO_(2) indicators of the two groups of patients were improved after treatment.The PaO_(2),PaCO_(2),and SaO_(2) indicators of the study group were significantly better than those of the control group after treatment,the difference was statistically significant(P<0.05);the study group patients after treatment of the HR index(86.58±10.21)times/min and RR index(22.76±5.41)times/min were significantly lower than those of the control group,the difference was statistically significant(t=2.683,6.553,P<0.05).Conclusion The nasal high-flow oxygen therapy replaces nasal cannula oxygen inhalation,combined with other conventional treatment methods,combined with refined nursing,has a better therapeutic effect on pulmonary tuberculosis complicated with typeⅠrespiratory failure,and it is worthy of further clinical application and promotion.