两种氧疗方式对AECOPD患者舒适度的比较研究

Comparative study on the effects of two oxygen therapies on the comfort of patients with AECOPD

目的:比较两种氧疗方式对慢性阻塞性肺疾病急性加重期(AECOPD)患者舒适度的影响。方法:选取南通市通州区人民医院ICU的64例AECOPD患者,随机分成经鼻高流量湿化氧疗(HFNC)组与无创持续气道正压通气(NIV-CPAP)组,各32例。比较两组患者的舒适度、不良反应及各项生命体征及实验室检查指标。结果:HFNC组的鼻部不适评分、咽部不适评分、胸部不适评分以及头部不适评分均低于NIV-CPAP组(P均<0.05)。HFNC组的恶心呕吐、呛咳、烦躁、鼻面部皮肤红肿发生率均低于NIV-CPAP组(P<0.05)。两组患者氧疗后HR,RR,MAP,PaO_(2),PaCO_(2)5项指标均较氧疗前有所改变,比较均有显著统计学差异(P<0.05);但两组患者氧疗后的5项指标比较均无显著统计学差异(P>0.05)。结论:相对于无创持续气道正压通气,经鼻高流量湿化氧疗患者的舒适度更高、不良反应更少,值得推广。

Objective:To compare the effects of two oxygen therapies on the comfort of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:64 patients with AECOPD in intensive care unit(ICU)of Nantong Tongzhou District People’s Hospital were randomly divided into high-flow nasal cannula(HFNC)group and non-invasive ventilation continuous positive airway pressure(NIV-CPAP)group,32 cases in each group.The comfort,adverse reactions and vital signs of the two groups were compared.Results:The nasal discomfort score,pharyngeal discomfort score,chest discomfort score and head discomfort score of HFNC group were lower than those of NIV-CPAP group(P<0.05).The incidences of nausea,vomiting,cough,irritability,skin redness and swelling in HFNC group were lower than those in NIV-CPAP group(P<0.05).After oxygen therapy,HR,RR,MAP,Pa0_(2) and PaC0_(2) of the two groups were significantly different from those before oxygen therapy(P<0.05).However,there was no significant difference in the five indexes between the two groups(P>0.05).Conclusion:Compared with using NIV-CPAP ventilation,the patients has higher comfort with HFNC and fewer adverse reactions,which is worthy of promotion.