经鼻高流量湿化氧疗对肺癌放射性肺炎合并呼吸衰竭患者的临床疗效观察

Clinical Observation of Nasal High Flow Humidifying Oxygen Therapy on Lung Cancer Patients with Radiation Pneumonitis and Respiratory Failure

目的:探究经鼻高流量湿化氧疗对肺癌放射性肺炎合并呼吸衰竭患者的临床疗效,以期为临床治疗提供参考。方法:选取2020年9月至2022年8月在我院呼吸内科住院的因肺癌放射治疗出现放射性肺炎合并呼吸衰竭患者86例为研究对象,根据氧疗方法的不同分为HFNC组和COT组,每组各43例,COT组患者在此基础上给予鼻导管供氧治疗。HFNC组患者给予HFNC氧疗方式。比较两组患者治疗前后血气分析指标、呼吸频率及舒适度、疲劳程度评分的差异及对比两组的预后情况。结果:治疗后12 h、24 h、48 h两组PaO_(2)//FiO_(2)/指标均较治疗前明显升高(P<0.05),且治疗后各个时间点HFNC组对PaO_(2)/FiO_(2)/指标改善明显优于COT组,差异具有统计学意义(P<0.01)。治疗后12 h、24 h、48 h两组呼吸频率均较治疗前明显降低(P<0.05),且治疗后各个时间点HFNC组对呼吸频率改善明显优于COT组,差异具有统计学意义(P<0.01)。治疗后两组患者舒适度评分均较治疗前明显升高、疲劳程度评分较治疗前明显降低(P<0.05),HFNC组对舒适度、疲劳程度评分改善程度明显优于COT组(P<0.01)。HFNC组患者气管插管占比、非机械通气天数明显少于COT组(P<0.01),死亡人数占比两组患者差异无统计学意义(P>0.05)。结论:经鼻高流量湿化氧疗可以改善肺癌放射性肺炎合并呼吸衰竭患者氧合指数,降低患者呼吸频率,改善患者舒适度和促进患者预后。

Objective:To explore the clinical effect of nasal high flow humidification oxygen therapy on lung cancer patients with radiation pneumonitis and respiratory failure,so as to provide reference for clinical treatment.Methods:86 patients with radiation pneumonitis and respiratory failure who were hospitalized in the respiratory department of our hospital from September 2020 to August 2022 due to radiation therapy of lung cancer were selected as the research objects.According to the different methods of oxygen therapy,they were divided into HFNC group and COT group,with 43 patients in each group.On this basis,patients in COT group were given nasal catheter oxygen therapy.Patients in HFNC group were given HFNC oxygen therapy.The differences of blood gas analysis indexes,respiratory rate,comfort and fatigue scores between the two groups before and after treatment were compared,as well as the prognosis of the two groups.Results:The PaO_(2)/FiO_(2) indexes in the two groups at 12 h,24 h and 48 h after treatment were significantly higher than those before treatment(P<0.05),and the improvement of PaO_(2)/FiO_(2) indexes in the HFNC group at each time point after treatment was significantly better than that in the COT group(P<0.01).The respiratory rate in the two groups at 12 h,24 h and 48 h afer treatment was significantly lower than that before treatment(P<0.05),and the improvement of respiratory rate in HFNC group was significantly better than that in COT group at each time point after treatment,with a statistically significant difference(P<0.01).After treatment,the comfort score of patients in both groups was significantly higher than that before treatment,and the fatigue score was significantly lower than that before treatment(P<0.05).The improvement of comfort score and fatigue score in HFNC group was significantly better than that in COT group(P<0.01).The proportion of tracheal intubation and days of non mechanical ventilation in HFNC group were significantly less than those in COT group(P<0.01),and there was no significant difference in the proportion of deaths between the two groups(P>0.05).Conclusion:Nasal high flow humidification oxygen therapy can improve the oxygenation index of lung cancer patients with radiation pneumonitis and respiratory failure,reduce their respiratory rate,improve their comfort and promote their prognosis.