膈肌超声对AECOPD撤机序贯经鼻高流量湿化氧疗和无创正压通气的评价作用

Evaluation Effect of Diaphragm Ultrasound on Weaning Sequential High-Flow Nasal Cannula Oxygen Therapy and Non-Invasive Positive Pressure Ventilation in AECOPD Patients

目的探讨膈肌超声对慢性阻塞性肺疾病急性加重期(AECOPD)撤机序贯经鼻高流量湿化氧疗(HFNC)和无创正压通气(NIPPV)的评价作用。方法将我院收治的40例AECOPD患者随机分为两组,A组行HFNC,B组行NIPPV治疗。采用膈肌超声评估两种治疗方式对患者膈肌功能的影响,比较两组治疗前后各时间点血流动力学变化。结果治疗后,A组吸气末膈肌厚度、呼气末膈肌厚度与膈肌增厚分数均高于B组(P<0.05)。治疗1 h、6 h、24 h、48 h后,A组的心率、MAP均低于B组(P<0.05)。结论膈肌超声可准确评估AECOPD撤机序贯HFNC和NIPPV对患者膈肌功能的改善作用,HFNC对AECOPD患者血流动力学的改善作用更加显著。

Objective To explore the evaluation effect of diaphragm ultrasound on weaning sequential high-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 40 AECOPD patients admitted to our hospital were randomly divided into two groups.Group A received HFNC,and group B received NIPPV.Diaphragm ultrasound was used to evaluate the impact of two treatment methods on patients'diaphragm function,and the hemodynamic changes at different time points before and after treatment were compared between the two groups.Results After treatment,the end inspiratory diaphragm thickness,end expiratory diaphragm thickness,and diaphragm thickening score of group A were higher than those of group B(P<0.05).After 1 hour,6 hours,24 hours,and 48 hours of treatment,the heart rates and MAP of group A were lower than those of group B(P<0.05).Conclusions Diaphragm ultrasound can accurately evaluate the effect of weaning sequential HFNC and NIPPV in improving diaphragm function in AECOPD patients,and HFNC has more significant improvement effect on hemodynamics in AECOPD patients.