高流量湿化治疗对慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者碳酸氢根与再插管率及舒适度的影响

Effect of high-flow humidification treatment on bicarbonate and reintubation rate and comfort patients with acute exacerbation of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure

目的探讨高流量湿化治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者的临床疗效。方法选取2019年8月至2021年4月本院收治的72例AECOPD合并Ⅱ型呼吸衰竭患者作为研究对象,采用随机数字表法分为两组,每组36例。对照组给予常规氧疗,观察组给予高流量湿化治疗,比较两组治疗前后碳酸氢根水平、气管再插管率及舒适度。结果治疗后,两组碳酸氢根水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组气管再插管率为2.78%,明显低于对照组的22.22%,差异有统计学意义(P<0.05)。观察组头痛、鼻部不适、咽喉部不适及胸部不适评分均明显低于对照组,差异有统计学意义(P<0.05)。结论高流量湿化治疗AECOPD合并Ⅱ型呼吸衰竭效果确切,可有效降低患者碳酸氢根水平及气管再插管率,提高患者治疗过程中的舒适度,具有较高的临床推广价值。

Objective To investigate the clinical efficacy of high-flow humidification in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡrespiratory failure.Methods 72 patients with AECOPD complicated with typeⅡrespiratory failure admitted to our hospital from August 2019 to April 2021 were selected as the study subjects,and they were divided into two groups by random number table method,with 36 cases in each group.The control group received routine oxygen therapy,while the observation group received high-flow humidification therapy,the levels of bicarbonate before and after treatment,tracheal reintubation rate,and comfort were compared between the two groups.Results After treatment,the levels of bicarbonate of the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The rate of tracheal reintubation in the observation group was 2.78%,which was significantly lower than the 22.22%in the control group,and the difference was statistically significant(P<0.05).The scores of headache,nasal discomfort,throat discomfort,and chest discomfort in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion High-flow humidification is effective in the treatment of AECOPD with typeⅡrespiratory failure,can effectively reduce the level of bicarbonate and the rate of tracheal re intubation in patients,improve the comfort of patients in the treatment process,and has high clinical promotion value.