高流量湿化氧疗和机械通气对IPF合并呼衰患者的疗效观察

Observation on the effect of high flow humidified oxygen therapy and mechanical ventilation in patients with IPF complicated with respiratory failure

目的探讨经鼻高流量湿化氧疗(HFNC)和机械通气(MV)对特发性肺纤维化(IPF)合并呼吸衰竭患者的死亡率和住院时间的影响。方法回顾性分析2017年1月至2021年2月该院收治的55例IPF合并呼吸衰竭的患者,其中40例接受单纯HFNC治疗(HFNC组),8例接受单纯MV治疗(MV组),7例先后接受HFNC、MV治疗(HFNC+MV组),比较3组住院总时间及住院死亡率。结果所有患者总死亡率为56.4%(31/55),其中HFNC组为47.5%(19/40),MV组为62.5%(5/8),HFNC+MV组为100.0%(7/7),3组比较差异有统计学意义(P<0.05)。HFNC组住院时间较MV组、HFNC+MV组明显缩短(P<0.05)。结论IPF合并呼吸衰竭的患者接受HFNC治疗失败后再继续MV治疗的死亡率明显高于仅接受HFNC或MV的治疗,单纯HFNC的治疗可以明显缩短患者的住院日。

Objective To investigate the mortality and length of hospital stay of patients with idiopathic pulmonary fibrosis(IPF)complicated with respiratory failure after nasal high flow humidifying oxygen therapy(HFNC)and mechanical ventilation(MV).Methods A total of 55 patients with IPF combined with respiratory failure admitted to a hospital from January 2017 to February 2021 were retrospectively analyzed.Among them,40 patients received HFNC treatment alone(the HFNC group),eight patients received MV treatment alone(the MV group),and seven patients received HFNC and MV treatment successively(the HFNC+MV group).The total length of stay and in-hospital mortality were compared among the three groups.Results The total mortality rate of all patients was 56.4%(31/55),including 47.5%(19/40)in the HFNC group,62.5%(5/8)in the MV group,and 100.0%(7/7)in the HFNC+MV group,and the difference among the three groups was statistically significant(P<0.05).In addition,the length of hospital stay in the HFNC group was significantly shorter than that in the MV group and the HFNC+MV group(P<0.05).Conclusion The mortality rate of patients with IPF complicated with respiratory failure after continuing MV treatment after failure of HFNC treatment is higher than that after only receiving HFNC or MV treatment.The treatment of HFNC alone could shorten the hospital stay of patients.