经鼻高流量氧疗联合多沙普仑治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的效果

ffect of Nasal High Flow Oxygen Therapy Combined with Doxapram in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Type Ⅱ Respiratory Failure

目的 探究经鼻高流量氧疗(HFNC)联合多沙普仑治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭(Ⅱ-RF)的效果。方法 前瞻性选取南阳市第一人民医院2021年2月至2023年2月收治的80例AECOPD合并Ⅱ-RF患者作为研究对象,按照随机数字法分为对照组和观察组,各40例。对照组接受HFNC等基础治疗,观察组在对照组的基础上接受多沙普仑治疗。比较两组肺功能、呼吸功能、氧化应激、血气分析指标水平以及用药安全性。结果 治疗后,两组第1秒用力呼气容积(FEV_(1))/用力肺活量(FVC)、呼气流量峰值(PEF)水平、平均动脉压(MAP)均高于治疗前,且观察组高于对照组(P<0.05);两组心率、呼吸频率(RR)、动脉血二氧化碳分压(PaCO_(2))、丙二醛(MDA)水平均低于治疗前,且观察组低于对照组(P<0.05);两组氧合指数(OI)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平高于治疗前,观察组高于对照组(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论 对AECOPD合并Ⅱ-RF患者应用HFNC联合多沙普仑治疗,可提升患者肺功能及呼吸功能,改善氧化应激水平,有效缓解病情,且不会明显增加药物不良反应。

Objective To investigate the effect of treatment with nasal high flow oxygen therapy(HFNC)combined with doxapram on chronic obstructive pulmonary disease patients with acute exacerbation(AECOPD)complicated by typeⅡrespiratory failure(Ⅱ-RF).Methods A prospective study was conducted on 80 AECOPD patients withⅡ-RF admitted to the First People’s Hospital of Nanyang City from February 2021 to February 2023.They were randomly divided into a control group and an observation group,with 40 patients in each group.The control group received basic treatment such as HFNC,while the observation group received doxapram treatment on the basis of the control group.The levels of pulmonary function,respiratory function,oxidative stress,blood gas analysis indexes,and the safety of medication were compared between the two groups.Results After treatment,forced expiratory volume in one second(FEV_(1))/forced vital capacity(FVC),peak expiratory flow(PEF)and mean arterial pressure(MAP)in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).The heart rate,respiratory rate(RR),arterial blood partial pressure of carbon dioxide(PaCO_(2)),and malondialdehyde(MDA)levels in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).The levels of oxygenation index(OI),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).There was no statistically difference in adverse reactions between the two groups(P>0.05).Conclusion The application of HFNC combined with doxapram in the treatment of AECOPD combined withⅡ-RF can improve lung and respiratory function,improve oxidative stress levels,effectively alleviate the condition,and not significantly increase drug adverse reactions.