高流量呼吸湿化治疗仪治疗老年低氧型呼吸衰竭的疗效及对患者血气及C反应蛋白、降钙素原水平的影响

The efficacy of high-flow respiratory humidification therapeutic apparatus in the treatment of elderly patients with hypoxic respiratory failure and its influence on blood gas and levels of C-reactive protein and procalcitonin

目的分析高流量呼吸湿化治疗仪(AIRVO_(2))对老年低氧型呼吸衰竭患者的治疗效果。方法收集2017年1月至2021年2月我院就诊的老年低氧型呼吸衰竭患者80例,采用随机数字表法分为AIRVO_(2)呼吸湿化组和对照组各40例。对照组给予经鼻正压通气吸氧及抗炎平喘等常规治疗,AIRVO_(2)呼吸湿化组在常规治疗的基础上给予AIRVO_(2)呼吸湿化治疗仪干预。比较两组治疗前及治疗72 h的血清相关因子水平C反应蛋白(CRP)、降钙素原(PCT)、氨基末端脑钠尿肽前体(NT-proBNP)、心率及呼吸指标心率(HR)、呼吸频率(RR)、最低血氧饱和度(LSaO_(2));比较两组治疗前、治疗24、48及72 h的动脉血氧分压(PaO_(2))、痰液黏稠度。结果治疗72 h,AIRVO_(2)呼吸湿化组血清CRP、PCT、NT-proBNP水平及HR、RR值均低于对照组,LSaO_(2)水平高于对照组,痰液粘稠度较对照组明显改善(P<0.05);AIRVO_(2)呼吸湿化组治疗24、48及72 h的PaO_(2)值均高于对照组(P<0.05)。结论AIRVO_(2)呼吸湿化治疗仪对老年低氧型呼吸衰竭患者的应用效果良好,可有效改善血气指标,降低应激及炎症反应,减少痰痂形成。

Objective To analyze the therapeutic effect of high-flow respiratory humidification therapeutic apparatus(AIRVO_(2))in the treatment of elderly patients with hypoxic respiratory failure.Methods Eighty elderly patients with hypoxic respiratory failure treated in our hospital between January 2017 and February 2021 were collected.The patients were divided into an AIRVO_(2) group and a control group according to the random number table method,40 in each group.The control group was given conventional treatments such as oxygen inhalation via nasal positive pressure ventilation,and anti-inflammatory and anti-asthmatic therapies.The AIRVO_(2) group was given AIRVO_(2) treatment on the basis of conventional treatments.The levels of serum related factors such as C-reactive protein(CRP),procalcitonin(PCT),and N-terminal pro-brain natriuretic peptide(NT-proBNP)and heart and respiratory indicators such as heart rate(HR),respiratory rate(RR),and lowest arterial oxygen saturation(LSaO_(2))before and after 72 hours of treatment were compared between the two groups.The arterial partial pressure of oxygen(PaO_(2))and sputum viscosity before treatment and after 24,48 and 72 hours of treatment were also compared between the two groups.Results After 72 hours of treatment,the levels of serum CRP,PCT,NT-proBNP,HR and RR in the AIRVO_(2) group were significantly lower than those in the control group(P<0.05)while the level of LSaO_(2) was significantly higher than that in the control group(P<0.05).The sputum viscosity in the AIRVO_(2) group was significantly improved when compared to the control group(P<0.05).The PaO_(2) value was significantly higher in the AIRVO_(2) group than that in the control group after 24,48 and 72 hours of treatment(P<0.05).Conclusion AIRVO_(2) respiratory humidification therapeutic apparatus has a good application effect in the treatment of elderly patients with hypoxic respiratory failure.It can effectively improve the blood gas indicators,reduce the stress response and inflammatory response,and lower the formation of sputum scab.