HFNC治疗COPD并发急性中度Ⅱ型呼吸衰竭的效果及对患者耐受性分析

Efficacy and Tolerance Analysis of HFNC in the Treatment of COPD Complicated with Acute Moderate Type Ⅱ Respiratory Failure

目的:探讨经鼻高流量加温湿化吸氧(HFNC)治疗慢性阻塞性肺疾病(COPD)并发急性中度Ⅱ型呼吸衰竭的效果及对患者耐受性的影响。方法:选取2018年5月-2020年3月赤壁市蒲纺医院收治的189例COPD并发急性中度Ⅱ型呼吸衰竭患者,按照随机数字表法将其分为观察组(n=95)和对照组(n=94)。对照组给予常规治疗,观察组给予HFNC治疗。比较两组症状改善情况、临床疗效、呼吸功能[两组血氧饱和度(SaO_(2))、氧合指数(OI)、动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))]及耐受性。结果:治疗前,两组COPD评估量表(CAT)、改良呼吸困难指数(mMRC)评分比较,差异均无统计学意义(P>0.05);治疗后,两组CAT、mMRC评分均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组总有效率为95.79%,高于对照组的87.23%,差异有统计学意义(P<0.05)。治疗前,两组SaO_(2)、OI、PaO_(2)、PaCO_(2)比较,差异均无统计学意义(P>0.05);治疗后,两组SaO_(2)、OI、PaO_(2)均高于治疗前,PaCO_(2)均低于治疗前,且观察组SaO_(2)、OI、PaO_(2)均高于对照组,PaCO_(2)低于对照组,差异均有统计学意义(P<0.05)。观察组治疗不耐受发生率低于对照组,差异均统计学意义(P<0.05)。结论:HFNC治疗COPD并发急性中度Ⅱ型呼吸衰竭可提升效果,有效改善患者临床症状及血气指标,并且耐受性良好。

Objective:To explore the effect of high-flow nasal cannula oxygen (HFNC) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with acute moderate type Ⅱ respiratory failure and its influence on patient tolerance.Method:A total of 189 patients with COPD complicated with acute moderate type Ⅱ respiratory failure admitted to Pufang Hospital of Chibi City from May 2018 to March 2020 were selected,they were divided into observation group (n=95) and control group (n=94) according to random number table method.The control group received conventional treatment,and the observation group received HFNC treatment.Symptom improvement,clinical efficacy,respiratory function[blood oxygen saturation (SaO_(2)),oxygenation index (OI),arterial partial pressure of oxygen (PaO_(2)),arterial partial pressure of carbon dioxide (PaCO_(2))]and tolerance were compared between two groups.Result:Before treatment,there were no significant differences in COPD assessment test (CAT) and modified medical research council dyspnea scale (mMRC) scores between two groups (P>0.05);after treatment,CAT and mMRC scores in both groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).The total effective rate in the observation group was 95.79%,which was higher than 87.23% in the control group,the difference was statistically significant (P<0.05).Before treatment,there were no significant differences in SaO_(2),OI,PaO_(2)and PaCO_(2)between two groups (P>0.05);after treatment,SaO_(2),OI and PaO_(2)in both groups were higher than those before treatment,PaCO_(2)in both groups was lower than those before treatment,and SaO_(2),OI and PaO_(2)in the observation group were higher than those in the control group,PaCO_(2)in the observation group was lower than that in the control group,the differences were statistically significant (P<0.05).The incidence of treatment intolerance in the observation group was lower than that in the control group,the differences was statistically significant (P<0.05).Conclusion:HFNC treatment of COPD complicated with acute moderate type Ⅱ respiratory failure can improve the curative effect,effectively improve the clinical symptoms and blood gas indicators of patients,and is well tolerated.