经鼻高流量湿化治疗仪联合支气管镜肺泡灌洗在重症肺炎合并低氧血症患者中的临床观察

Clinical effects of trans-nasal high flow humidification therapy apparatus combined with bronchoscope alveolar lavage in severe pneumonia patients complicated with hypoxemia

目的:观察经鼻高流量湿化治疗仪联合支气管镜肺泡灌洗(BAL)在重症肺炎合并低氧血症患者中的应用效果。方法:选择86例重症肺炎合并低氧血症患者患者,按随机数字表法将其分为两组。对照组采用BAL治疗,观察组采用经鼻高流量湿化治疗仪、BAL联合治疗,比较两组血气指标、健康状况、ICU入住率及30 d病死率。结果:治疗后,观察组二氧化碳分压(PaCO_(2))[(38.42±4.69)mmHg]低于对照组,氧分压(PaO_(2))[(80.64±8.52)mmHg]及血氧饱和度(SaO_(2))[(98.13±0.73)%]高于对照组,急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分[(14.36±4.71)分]低于对照组,重症监护室(ICU)入住率(4.65%)低于对照组,差异有统计学意义(P<0.05);两组30 d病死率比较,无统计学差异(P>0.05)。结论:在重症肺炎合并低氧血症患者中采用经鼻高流量湿化治疗仪、BAL联合治疗是行之有效的,可改善患者血气指标及健康状态,减少ICU入住率,促进病情恢复。

Objective:To observe the effects of trans-nasal high-flow humidification therapy instrument combined with bronchoscopy alveolar lavage(BAL)in severe pneumonia patients complicated with hypoxemia.Methods:Eighty-six severe pneumonia patients complicated with hypoxemia were randomized into two groups,each with 43 cases.The control group were treated with BAL,while the observation group were treated with trans-nasal high-flow humidification therapeutic apparatus and BAL.The blood gas indicators,health status,ICU occupancy rate and 30-day mortality rate were compared between the two groups.Results:After treatment,the partial pressure of carbon dioxide(PaCO_(2))[(38.42±4.69)mmHg]of the observation group was lower than that of the control group;the partial pressure of oxygen(PaO_(2))[(80.64±8.52)mmHg]and blood oxygen saturation(SaO_(2))[(98.13±0.73)%]was higher than that of the control group respectively;the acute physiology and chronic health status II(APACHE II)score[(14.36±4.71)points]was lower than that of the control group;and the occupancy rate of the intensive care unit(ICU)(4.65%)was lower than that of the control group;and there were statistical differences between both groups(P<0.05).However,there was no statistical difference in the 30-day mortality rate between the two groups(P>0.05).Conclusion:For severe pneumonia patients complicated with hypoxemia,the combined treatment of trans-nasal high-flow humidification therapy apparatus with BAL is effective,which can improve the blood gas indicators and health status of the patients,reduce the ICU occupancy rate,and promote the recovery of patients.