有创通气与经鼻高流量鼻导管湿化氧疗序贯治疗肺炎合并呼吸衰竭患者的临床效果

Clinical effect of sequential treatment of invasive ventilation and transnasal high-flow nasal catheter humidification oxygen therapy on patients with pneumonia complicated with respiratory failure

目的 探讨有创通气与经鼻高流量鼻导管湿化氧疗序贯治疗肺炎合并呼吸衰竭患者的临床效果。方法 选取2020年10月至2021年10月我院收治的50例肺炎合并呼吸衰竭患者为研究对象,将其随机分为对照组(25例,有创通气+无创正压通气)与观察组(25例,有创通气+经鼻高流量鼻导管湿化氧疗)。比较两组患者的治疗效果。结果 观察组的治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的PaCO_(2)均降低,PaO_(2)、SaO_(2)均升高,且观察组明显优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的IL-10水平均升高,TNF-α、CRP水平均降低,且观察组明显优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的RR、MAP、HR均降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的NT-proBNP、cTnI、CK-MB水平均降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论 有创通气与经鼻高流量鼻导管湿化氧疗序贯治疗肺炎合并呼吸衰竭的临床效果显著,可改善患者的血气指标及炎性指标,降低RR、MAP、HR,改善心肌损伤程度,降低并发症发生率,值得临床进一步推广和应用。

Objective To explore the clinical effect of sequential treatment of invasive ventilation and transnasal highflow nasal catheter humidification oxygen therapy on patients with pneumonia complicated with respiratory failure.Methods A total of 50 patients with pneumonia complicated with respiratory failure dmitted in our hospital from October 2020 to October 2021 were selected as the research objects and randomly divided into control group(25 cases,invasive ventilation+ noninvasive positive pressure ventilation) and observation group(25 cases,invasive ventilation + transnasal high-flow nasal catheter humidification oxygen therapy).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,PaCO_(2)in the two groups decreased,while PaO_(2)and SaO_(2)increased,those in the observation group were significantly better than the control group,and the differences were statistically significant(P<0.05).After treatment,the level of IL-10 in the two groups increased,and the levels of TNF-αand CRP decreased,those in the observation group were significantly better than the control group,the differences were statistically significant(P <0.05).After treatment,the RR,MAP and HR in the two groups decreased,those in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of NT-proBNP,cTnI and CK-MB in the two groups decreased,those in the observation group were significantly lower than the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P <0.05).Conclusion Sequential treatment of invasive ventilation and transnasal high-flow nasal catheter humidification oxygen therapy in the treatment of pneumonia complicated with respiratory failure has a significant clinical effect,it can improve the blood gas indexes and inflammatory indexes of patients,reduce the RR,MAP,HR,improve the degree of myocardial injury,and reduce the incidence of complications,which is worth of further promotion and application in clinic.