高流量呼吸湿化治疗仪在NTM肺病合并支气管扩张患者气道廓清中的应用效果

Effect of high flow nasal cannula oxygen therapy on airway clearance in patients with NTM pulmonary disease complicated by bronchiectasis

目的探讨高流量呼吸湿化治疗仪在非结核分枝杆菌(NTM)肺病合并支气管扩张患者中的气道廓清效果。方法选取广州市胸科医院2020年5月至2021年12月收治的NTM肺病合并支气管扩张患者80例为研究对象,按照随机数字表法分为研究组和对照组,每组40例。两组患者均神志醒,一般情况良好,长期咳嗽、咳痰,痰液黏稠且不易咳出,伴有不同程度气促和呼吸困难。对照组给予抗结核、抗感染及常规护理,研究组在此基础上采用高流量呼吸湿化治疗仪辅助通气。对两组患者上机前、上机3d、7d后的呼吸道症状和呼吸运动进行评估。结果研究组进行高流量呼吸湿化治疗仪辅助通气前患者的呼吸道症状评分为(2.70±0.46)分,与对照组[(2.57±0.5)分]比较,差异未见统计学意义(P>0.05)。研究组上机3d、7d后评分为(1.70±0.46)分、(0.38±0.49)分,与对照组[(2.50±0.59)分、(1.67±0.57)分]比较,差异均有统计学意义(P均<0.05)。研究组上机前呼吸困难程度为(2.70±0.75)分,与对照组[(2.67±0.65)分]比较,差异未见统计学意义(P>0.05)。研究组上机3d、7d后呼吸困难程度为(1.73±0.75)分、(0.63±0.66)分,与对照组[(2.65±0.69)分、(1.65±0.66)分]比较,差异均有统计学意义(P均<0.05)。结论高流量呼吸湿化治疗仪在NTM肺病合并支气管扩张患者气道廓清中的应用效果明显,能够充分湿化气道,促进气道分泌物的有效排出,改善患者呼吸道症状,提高活动耐受能力。

Objective To investigate the effect of high flow nasal cannula oxygen therapy on airway clearance in patients with NTM pulmonary disease complicated with bronchiectasis.Methods A total of 80 patients with NTM pulmonary disease complicated with bronchiectasis in Guangzhou Chest Hospital from May 2020 to December 2021 were selected and randomly divided into study group and control group,with 40 cases in each group.The patients in both groups were conscious and generally in good condition,with long-term cough and expectoration.The sputum was viscous and difficult to cough,accompanied by varying degrees of shortness of breath and dyspnea.The control group was given anti-tuberculosis,anti-infection and routine nursing,and the study group was given high flow nasal cannula oxygen therapy to assist ventilation on this basis.The respiratory symptoms and respiratory movements of the two groups were evaluated before,3 days and 7 days after using the machine.Results The respiratory symptom score of the study group was(2.70±0.46)points,compared with the control group[(2.57±0.5)points],and the difference was not significant(P>0.05).The scores of 3 days and 7 days after the machine were(1.70±0.46)and(0.38±0.49),compared with those of the control group[(2.50±0.59)and(1.67±0.57)],and the differences were significant(both P<0.05).The degree of dyspnea in the study group was(2.70±0.75)points,compared with the control group[(2.67±0.65)points],and the difference was not significant(P>0.05).The degree of dyspnea after 3 days and 7 days were(1.73±0.75)points and(0.63±0.66)points,compared with the control group[(2.65±0.69)points and(1.65±0.66)points],and the differences were significant(both P<0.05).Conclusions The application effect of high flow nasal cannula oxygen therapy on airway clearance of patients with NTM pulmonary disease complicated with bronchiectasis is obvious,which can fully humidify the airway,promote the effective discharge of airway secretions,improve respiratory symptoms,and improve activity tolerance.