经鼻高流量氧疗结合康复治疗在脑损伤伴呼吸衰竭患者中的应用价值研究

Study on practical value of nasal high-flow oxygen therapy combined with rehabilitation therapy in patients with brain injury and respiratory failure

目的分析经鼻高流量氧疗结合康复治疗在脑损伤伴呼吸衰竭患者中的应用价值。方法100例脑损伤伴呼吸衰竭患者,采用随机数字表法分为对照组和观察组,每组50例。对照组患者给予面罩式无创正压通气结合康复治疗,观察组患者给予经鼻高流量氧疗结合康复治疗。比较两组咳痰难度评分、咳痰舒适度评分、咳痰耐受性评分,治疗前后呼吸频率、氧合指数、二氧化碳分压、氧分压,3个月内死亡率。结果观察组咳痰难度评分(2.01±0.12)分、咳痰舒适度评分(1.24±0.12)分、咳痰耐受性评分(1.10±0.23)分均低于对照组的(3.56±0.21)、(2.78±0.23)、(2.25±0.12)分,差异有统计学意义(P<0.05)。治疗前,两组患者的呼吸频率、氧合指数、二氧化碳分压、氧分压比较差异无统计学意义(P>0.05);治疗后,观察组患者的呼吸频率(17.56±3.21)次/min、二氧化碳分压(42.19±2.50)mm Hg(1 mm Hg=0.133 kPa)均显著低于对照组的(20.51±2.44)次/min、(46.14±2.12)mm Hg,氧合指数(388.56±23.21)mm Hg、氧分压(89.19±5.31)mm Hg均显著高于对照组的(350.72±21.21)、(82.14±4.56)mm Hg,差异有统计学意义(P<0.05)。观察组3个月内死亡率为2.00%(1/50),低于对照组的16.00%(8/50),差异有统计学意义(P<0.05)。结论经鼻高流量氧疗结合康复治疗在脑损伤伴呼吸衰竭患者中的应用价值高,可提高咳痰舒适度,降低咳痰难度,改善血气分析,并降低死亡率。

Objective To analyze the practical value of nasal high-flow oxygen therapy combined with rehabilitation therapy in patients with brain injury and respiratory failure.Methods A total of 100 patients with brain injury and respiratory failure were divided into a control group and an observation group according to random numerical table,with 50 cases in each group.The control group was given non-invasive positive pressure ventilation combined with rehabilitation treatment,and the observation group was given nasal high-flow oxygen therapy combined with rehabilitation therapy.Both groups were compared in terms of score of difficulty in expectoration,score of comfort in expectoration,sputum tolerance score,respiratory rate,oxygenation index,partial pressure of carbon dioxide and partial pressure of oxygen before and after treatment,and mortality within 3 months.Results The score of difficulty in expectoration in the observation group was(2.01±0.12)points,the score of comfort in expectoration was(1.24±0.12)points and the sputum tolerance score was(1.10±0.23)points,which were all lower than those of(3.56±0.21),(2.78±0.23)and(2.25±0.12)points in the control group.The differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in respiratory rate,oxygenation index,partial pressure of carbon dioxide and partial pressure of oxygen between the two groups(P>0.05).After treatment,the respiratory rate of(17.56±3.21)times/min and the partial pressure of carbon dioxide of(42.19±2.50)mm Hg(1 mm Hg=0.133 kPa)in the observation group were significantly lower than those of(20.51±2.44)times/min and(46.14±2.12)mm Hg in the control group;the oxygenation index of(388.56±23.21)mm Hg and partial pressure of oxygen of(89.19±5.31)mm Hg in the observation group were significantly higher than those of(350.72±21.21)and(82.14±4.56)mm Hg in the control group.The differences were statistically significant(P<0.05).The mortality rate within 3 months in the observation group was 2.00%(1/50),which was lower than that of 16.00%(8/50)in the control group,and the difference was statistically significant(P<0.05).Conclusion Nasal high-flow oxygen therapy combined with rehabilitation therapy is of high value in patients with brain injury and respiratory failure.It can improve the comfort in expectoration,reduce the difficulty in expectoration,improve blood gas analysis,and reduce mortality.