鼻高流量氧疗治疗慢阻肺合并Ⅱ型呼吸衰竭的临床效果

The Clinical Effect of Nasal High-flow Oxygen Therapy in the Treatment of Chronic Obstructive Pulmonary with TypeⅡRespiratory Failure

目的探讨经鼻高流量氧疗治疗老年慢阻肺合并Ⅱ型呼吸衰竭的临床效果。方法方便选取2019年5月—2020年3月该院诊治的慢阻肺合并Ⅱ型呼吸衰竭老年患者96例,随机平均分为两组。对照组(n=48)患者给予无创正压通气治疗,观察组(n=48)患者给予经鼻高流量氧疗治疗。比较对照组和观察组患者治疗前后的呼吸频率、心率、动脉血气分析指标及FEV1%与慢阻肺症状(CAT)评分。结果两组患者经治疗后,观察组呼吸频率(20.92±3.77)次/min、心率(85.67±8.82)次/min、MAP(85.22±6.16)mmHg、PaCO_(2)(48.12±4.36)mmHg低于对照组(23.82±4.81)次/min、(91.36±8.93)次/min、(91.18±4.83)mmHg、(51.43±4.94)mmHg,PaO_(2)(85.37±8.51)mmHg高于对照组(76.91±8.47)mmHg,差异有统计学意义(t=3.288、3.141、5.275、3.480、4.882,P<0.05)。观察组患者的FEV1%(84.51±7.65)%高于对照组(73.18±8.57)%,CAT评分(13.42±2.87)分低于对照组(18.21±2.86)分,差异有统计学意义(t=3.288、3.141,P<0.05)。结论经鼻高流量氧疗治疗可有效改善老年慢阻肺合并Ⅱ型呼吸衰竭患者的临床症状及动脉血气分析指标,临床治疗意义重大,值得推广应用。

Objective To explore the clinical effect of nasal high-flow oxygen therapy in the treatment of elderly chronic obstructive pulmonary with typeⅡrespiratory failure.Methods A total of 96 elderly patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure who came to the hospital for diagnosis and treatment from May 2019 to March 2020 were conveniently selected and randomly divided into two groups.Patients in the control group(n=48)were treated with non-invasive positive pressure ventilation,and patients in the observation group(n=48)were treated with nasal high-flow oxygen therapy.The respiratory rate,heart rate,arterial blood gas analysis index,FEV1%and chronic obstructive pulmonary symptoms(CAT)scores of the control group and observation group before and after treatment were compared.Results After the two groups of patients were treated,the observation group's respiratory frequency(20.92±3.77)beats/min,heart rate(85.67±8.82)beats/min,MAP(85.22±6.16)mmHg,PaCO_(2)(48.12±4.36)mmHg were lower than those of the control group(23.82±4.81)times/min,(91.36±8.93)times/min,(91.18±4.83)mmHg,(51.43±4.94)mmHg.PaO_(2)(85.37±8.51)mmHg was higher than the control group(76.91±8.47)mmHg,the difference was statistically significant(t=3.288,3.141,5.275,3.480,4.882,P<0.05).The FEV1%(84.51±7.65)%of the observation group was higher than that of the control group(73.18±8.57)%,and the CAT score(13.42±2.87)points was lower than the control group(18.21±2.86)points,the difference was statistically significant(t=3.288,3.141,P<0.05).Conclusion Nasal high-flow oxygen therapy can effectively improve the clinical symptoms and arterial blood gas analysis indicators of elderly patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure.The clinical treatment is of great significance and is worthy of popularization and application.