经鼻高流量湿化氧疗与无创正压通气应用于AECOPD合并Ⅱ型呼吸衰竭疗效比较

To compare the efficacy of nasal high-flow humidification oxygen therapy and non-invasive positive pressure ventilation in the treatment of AECOPD with type Ⅱ respiratory failure

目的 探讨经鼻高流量湿化氧疗(HFNC)与无创正压通气(NIPPV)应用于慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭(PaCO_(2)≤75mmHg)的临床疗效。方法 回顾性分析2021年6月~2022年6月收治的AECOPD合并Ⅱ型呼吸衰竭患者的临床资料,分为HFNC组和NIPPV组,各32例,比较两组患者的动脉血气分析、SpO_(2)、RR、HR及治疗后48h护理气道次数、通气治疗时间、并发症发生率(颜面部皮肤破损、胃肠胀气)等指标情况。结果 两组患者治疗后pH、PaO_(2)、SpO_(2)、RR、HR、通气治疗时间比较,差异无统计学意义(P>0.05),治疗后1h PaCO_(2)、48h内护理气道次数、并发症发生率低于NIPPV组,差异有统计学意义(P<0.05)。结论 HFNC与NIPPV两种治疗方式均可作为AECOPD合并Ⅱ型呼吸衰竭患者的通气方式,但HFNC耐受性好,并发症发生率更低。

Objective To investigate the clinical value of high flow nasal cannula(HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with type Ⅱ respiratory failure(PaCO_(2)≤75mmHg).Methods Patients with AECOPD complicated with type Ⅱ respiratory failure admitted to our hospital from June 2021 to June 2022 were retrospectively analyzed.They were divided into HFNC group and NIPPV group, with 32 cases in each group.Arterial blood gas analysis, SpO_(2),RR,HR,the number of nursing airway within 48 hours after treatment, ventilation treatment time, incidence of complications(facial skin damage, flatulence) and other indicators were compared between the two groups.Results There was no significant difference in pH,PaO_(2),SpO_(2),RR,HR and ventilation treatment time between the two groups after treatment(P>0.05).The PaCO_(2)one hour after treatment, the number of nursing airways within 48 hours, and the incidence of complications in the HFNC groups were lower than those in the NIPPV group, and the differences were statistically significant(P<0.05)Conclusion Both HFNC and NIPPV can be used as ventilation methods for AECOPD patients with type Ⅱ respiratory failure, but HFNC is better tolerated and has a lower incidence of complications.