呼吸湿化治疗仪在治疗慢性阻塞性肺疾病合并呼吸衰竭气管插管患者的临床价值

Clinical Value of Respiratory Humidification Therapy Apparatus in the Treatment of Patients with Chronic Obstruc⁃tive Pulmonary Disease Complicated by Respiratory Failure with Tracheal Intubation

目的:观察呼吸湿化治疗仪治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭气管插管患者的效果。方法:选取2018年12月—2020年6月肇庆市第一人民医院收治的90例COPD合并呼吸衰竭气管插管患者作为研究对象,采用抽签法分为观察组和对照组,每组各45例。对照组常规给氧、湿化气道,观察组使用呼吸湿化治疗仪。对比两组患者生命体征、血气指标、炎症因子水平、痰痂形成率及拔管效果。结果:两组患者治疗前生命体征、炎症因子水平、血气指标比较,差异无统计学意义(t=0.881、0.891,P>0.05;t=1.555、0.384、0.804、1.159,P>0.05;t=0.235,P>0.05)。治疗后,观察组心率、呼吸频率改善明显,C反应蛋白(CRP)降低更显著,血气指标优于对照组,差异有统计学意义(t=4.798、3.373,P<0.05;t=10.789、4.728、10.831、6.491,P<0.05;t=3.514,P<0.05)。观察组痰痂形成率低于对照组,拔管成功率高于对照组,差异有统计学意义(χ^(2)=5.075,4.865,P<0.05)。结论:呼吸湿化治疗仪治疗COPD合并呼衰气管插管可改善患者生命体征、炎症因子水平、血气指标,减少痰痂形成,有利于拔管成功,值得推广。

Objective:To observe the effect of respiratory humidification therapy instrument in the treatment of chronic obstruc⁃tive pulmonary disease(COPD)patients with respiratory failure and tracheal intubation.Methods:A total of 90 patients with COPD complicated by tracheal intubation with respiratory failure who were admitted to the hospital from December 2018 to June 2020 were selected and divided into an observation group and a control group by drawing lots,with 45 cases in each group.The control group was given routine oxygen and humidified airway,and the observation group was given respiratory humidification treat⁃ment instrument.The vital signs,blood gas indexes,inflammatory factor levels,sputum scab formation rate and extubation effect of the two groups were compared.Results:There was no statistically significant difference in vital signs,inflammatory factor levels and blood gas indexes between the two groups before treatment(t=0.881,0.891,P>0.05,t=1.555,0.384,0.804,1.159,P>0.05,t=0.235,P>0.05).After treatment,the heart rate and respiratory rate of the observation group improved significantly,the C-reactive protein(CRP)decreased more significantly,and the blood gas indexes were better than those of the control group,and the difference was statistically significant(t=4.798,3.373,P<0.05,t=10.789,4.728,10.831,6.491,P<0.05,t=3.514,P<0.05).The formation rate of sputum scab in the observation group was lower than that in the control group,and the success rate of extubation was higher than that in the control group,and the differences were statistically significant(χ^(2)=5.075,4.865,P<0.05).Conclusion:Endotracheal intubation can improve vital signs,inflammatory factor levels and blood gas indexes of COPD patients with respiratory failure,reduce the formation of sputum scab,and is conducive to successful extubation,which is worthy of promotion.