高流量湿化氧疗联合肠内营养支持对老年肺炎患者氧合指数及炎症因子的影响

The impact of high-flow humidification oxygen therapy combined with enteral nutrition support on oxygenation index and inflammatory factors in elderly patients with pneumonia

目的研究分析老年肺炎患者经高流量湿化氧疗联合肠内营养支持后对氧合指数和炎症因子的影响。方法选择2018年1月—2020年12月本院收治的120肺炎患者作为研究对象,随机分为对照组和观察组两组,每组各60例。两组患者均给予常规治疗,包括抗感染、止咳、祛痰、纠正水电解质以及根据病情给予机械通气等治疗;对照组在此基础上给予经鼻高流量鼻导管湿化氧疗,观察组在对照组治疗方法基础上联合采用肠内营养支持治疗。观察经高流量湿化氧疗联合肠内营养支持治疗后两组老年肺炎患者的氧合指数及炎症因子的影响。结果治疗一周后观察组临床疗效总有效率为88.33%,优于对照组的65%(P<0.05)。两组患者治疗前各项指标比较,差异均无统计学意义(P>0.05);治疗后相较于治疗前,差异均有统计学意义(P<0.05)。治疗前后呼吸频率RR对照组[(25.56±2.14)次/min vs 23.17±2.22)次/min],观察组[(24.77±2.39)次/min vs(21.01±2.12)次/min],组间差异具有统计学意义(P<0.05);治疗前后氢离子浓度指数PH值对照组[(7.34±0.02)vs(7.35±0.03)],观察组[(7.33±0.05)vs(7.39±0.02)],组间差异具有统计学意义(P<0.05);治疗前后氧分压对照组[(72.11±12.87)mmHg vs(77.14±11.58)mmHg],观察组[(75.66±11.98)mmHg vs(82.64±12.07)mmHg],两组患者比较差异具有统计学意义(P<0.05);治疗前后氧合指数对照组[(238.44±41.17)mmHg vs(221.54±42.15)mmHg],观察组[(224.11±41.33)mmHg vs(240.55±40.11)mmHg],组间差异具有统计学意义(P<0.05);治疗前后二氧化碳分压对照组[(50.11±11.88)mmHg vs(51.97±10.44)mmHg],观察组[(54.11±12.88)mmHg vs(47.44±9.56)mmHg],组间差异具有统计学意义(P<0.05)。结论老年肺炎患者在常规治疗及高流量湿化氧疗的同时,经早期给予肠内营养制剂后临床疗效显著,氧合指数提升明显,改善呼吸功能效果明显,同时可有效降低患者体内炎性因子,且并发症发生率较低,安全性较高。

Objective To study and analyze the effect of high-flow humidified oxygen therapy combined with enteral nutrition support on oxygenation index and inflammatory factors in elderly patients with pneumonia.Methods A total of 120 patients suffer from pneumonia those were admitted to our hospital from January 2018 to December 2020 were enrolled as study subjects.According to random number table method,they were divided into control group and observation group,60 cases in each group.Both groups were given conventional treatment,including anti-infection,antitussive,expectorant,correction of water and electrolytes,and mechanical ventilation according to their conditions.On this basis,the control group was given humidified oxygen therapy via nasal high-flow nasal cannula,and the observation group was given enteral nutrition support based on the treatment method of the control group.Effects of oxygenation index and inflammatory factors in elderly patients with pneumonia was observed after the treatment of high-flow humidified oxygen therapy combined with enteral nutrition support.Results After one week of treatment,the total effective rate of the observation group was 88.33%,which was better than 65%in the control group,and the difference was statistically significant(P<0.05).There was no statistical significance in all indexes between the two groups before treatment(P>0.05).After treatment,the differences were statistically significant compared with those before treatment(P<0.05).RR score of respiratory rate before and after treatment was 25.56±2.14 and 23.17±2.22 in control group,and 24.77±2.39 and 21.01±2.12 in observation group,the difference between groups was statistically significant(P<0.05).Hydrogen ion concentration index PH value before and after treatment in the control group were 7.34±0.02 and 7.35±0.03,those in the observation group were 7.33±0.05 and 7.39±0.02,the difference between the two groups of patients was statistically significant(P<0.05).The partial pressure of oxygen before and after treatment in the control group were 72.11±12.87 and 77.14±11.58,those in the observation group were 75.66±11.98 and 82.64±12.07,the difference between the two groups was statistically significant(P<0.05).Oxygenation index before and after the treatment in control group were 238.44±41.17 and 221.54±42.15,those in the observation group were 224.11±41.33 and 240.55±40.11,the difference between the two groups was statistically significant(P<0.05).The partial pressure of carbon dioxide before and after treatment in the control group were 50.11±11.88 and 51.97±10.44,those in the observation group were 54.11±12.88 and 47.44±9.56,the difference between the two groups was statistically significant(P<0.05).Conclusions In addition to conventional treatment and high-flow humidifying oxygen therapy,the early administration of enteral nutrition has significant clinical efficacy,with significant improvement of oxygenation index and respiratory function.At the same time,it could effectively reduce inflammatory factors in patients with low complication rate and high safety.