经鼻高流量湿化氧疗在老年肺炎合并低氧血症患者中的疗效研究

High-Flow Nasal Cannula Oxygen Therapy for Older Adults with Pneumonia Complicated by Hypoxemia

目的 探讨在老年肺炎合并低氧血症患者中应用经鼻高流量湿化氧疗(HFNC)的疗效。方法 选取2019年10月~2022年2月入院且年龄≥65岁的48例肺炎合并低氧血症患者作为研究对象,按照随机数字表法分为HFNC组和普通氧疗(COT)组,各24例。收集患者一般资料及氧合状况、排痰综合能力评分、氧疗效果等临床资料,观察干预后痰液黏稠程度、氧合状况及肺炎转归情况。结果 HFNC组治疗后48 h的氧合指数高于COT组、排痰综合能力评分低于COT组,住院时间短于COT组,7 d氧疗失败发生率低于COT组,治疗后痰液引流困难率低于COT组,差异均有统计学意义(P<0.05);两组7 d插管率比较,差异无统计学意义(P>0.05)。结论 与COT比较,HFNC可显著改善老年肺炎合并低氧血症患者的氧合指数,缩短住院时间,降低氧疗失败率,在痰液引流困难的老年患者中经鼻高流量湿化氧疗优势尤其明显。

Objective To investigate the efficacy of high-flow nasal cannula(HFNC) oxygen therapy in older patients with pneumonia complicated by hypoxemia.Methods A total of 48 hospitalized patients aged≥65 years with pneumonia and hypoxemia from October 2019 to February 2022 were enrolled.The patients were divided into an HFNC group(24 cases) and a COT group(24 cases) according to random number table.The HFNC group was given HFNC oxygen therapy, the COT group was given conventional oxygen therapy(COT).Clinical data were collected, including general information, oxygenation status, ability to expectorate, and efficacy of oxygen therapy.Sputum viscosity, oxygenation status, and pneumonia prognosis were evaluated.Results At 48 hours after oxygen treatment, compared with the COT group, the HFNC group had a higher oxygenation index and a lower expectoration score.Compared with the COT group, the HFNC group had a shorter length of hospitalization, a less oxygen therapy failure within 7 days, and a less sputum drainage difficulty.The differences between the two groups were statistically significant(P<0.05).There was no significant difference in intubation rate between the two groups within 7 days(P>0.05).Conclusion Compared with COT,HFNC oxygen therapy may significantly improve the oxygenation index, decrease hospital length of stay, and reduce failure of oxygen therapy in patients with pneumonia complicated by hypoxemia, especially in patients with difficulty in expectoration.