经鼻高流量氧疗治疗老年慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床疗效分析

Clinical Efficacy Analysis of Transnasal High-Flow Oxygen Therapy in Treatment of Chronic Obstructive Pulmonary Diseases Combined with Type II Respiratory Failure in the Elderly

目的:分析经鼻高流量氧疗治疗老年慢性阻塞性肺疾病(简称慢阻肺)合并Ⅱ型呼吸衰竭的临床疗效。方法:选取2022年1-3月唐山市工人医院呼吸与危重症医学科收治的慢阻肺合并Ⅱ型呼吸衰竭老年患者84例为观察对象,根据随机数字表法分为对照组与观察组,各42例。对照组采用无创正压通气治疗,观察组采用经鼻高流量氧疗治疗。比较两组患者肺功能[用力肺活量(FVC)、1 s用力呼吸容积(FEV_(1))、FEV_(1)占FVC之比(FEV_(1)/FVC)],血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))],症状缓解时间。结果:治疗后,两组患者肺功能指标FVC、FEV_(1)、FEV_(1)/FVC水平均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者PaO_(2)水平均升高,PaCO_(2)水平均降低,且观察组PaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组症状缓解时间均缩短,且观察组短于对照组,差异有统计学意义(P<0.05)。结论:对于老年慢阻肺合并Ⅱ型呼吸衰竭患者,经鼻高流量吸氧可有效提高老年患者肺功能,改善血气指标,缩短症状缓解时间。

Objective:To analyze the clinical efficacy of transnasal high-flow oxygen therapy in the treatment of chronic obstructive pulmonary diseases combined with typeⅡrespiratory failure in the elderly.Methods:Eighty-four elderly patients with chronic obstructive pulmonary diseases combined with typeⅡrespiratory failure admitted to Department of Respiratory and Critical Care Medicine,Tangshan Workers'Hospital from January to March 2022 were selected as observation subjects,and were divided into control group and observation group according to the random number table method,with forty-two cases in each group.The control group was treated with noninvasive positive pressure ventilation,and the observation group was treated with transnasal high-flow oxygen therapy.Pulmonary function[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV_(1)),ratio of FEV_(1) to FVC(FEV_(1)/FVC)],blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],and symptom relief time were compared between the two groups.Results:After treatment,the levels of pulmonary function indexes FVC,FEV_(1) and FEV_(1)/FVC increased in both groups,and the observation group was higher than the control group.The difference was statistically significant(P<0.05).After treatment,PaO_(2) levels increased and PaCO_(2) levels decreased in both groups.The PaO_(2) level in the observation group was higher than that in the control group,and the PaCO_(2) level in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the time of symptom relief was shortened in both groups,and the observation group was shorter than the control group.The difference was statistically significant(P<0.05).Conclusion:For elderly patients with chronic obstructive pulmonary diseases combined with typeⅡrespiratory failure,transnasal high-flow oxygenation can effectively improve pulmonary function,improve blood gas index and shorten the time to symptom relief in elderly patients.