经鼻高流量氧疗用于老年肺炎伴低氧血症患者的疗效

Efficacy of high-flow nasal cannula oxygen therapy in patients with senile pneumonia and hypoxemia

目的分析经鼻高流量氧疗(HFNC)用于老年肺炎伴低氧血症患者的疗效。方法选取2020年9月至2021年6月于南昌三三四医院呼吸科就诊的66例老年肺炎伴低氧血症患者作为研究对象,按照随机数字表法分为对照组与观察组,各33例。两组均接受常规治疗,对照组行常规鼻导管吸氧治疗,观察组行HFNC,比较两组呼吸频率、心率、动脉血氧分压、血氧饱和度、舒适度评分、呼吸困难症状缓解时间、住院时间、机械通气发生率。结果治疗48h,两组呼吸频率、心率均低于治疗前,动脉血氧分压、血氧饱和度均高于治疗前,且观察组呼吸频率、心率均低于对照组,动脉血氧分压、血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。治疗2、48h,观察组视觉模拟评分法(VAS)评分均低于前一时间点,差异有统计学意义(P<0.05);对照组治疗前后各时间点VAS评分两两比较差异无统计学意义。治疗前、治疗2h,两组VAS评分比较差异无统计学意义;治疗48h,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组呼吸困难症状缓解时间、住院时间均短于对照组,机械通气发生率低于对照组,差异有统计学意义(P<0.05)。结论HFNC能有效改善老年肺炎伴低氧血症患者的缺氧状态,提高舒适度,加快呼吸困难症状缓解,降低机械通气率。

Objective To analyze the efficacy of high-flow nasal cannula oxygen therapy(HFNC)in patients with senile pneumonia and hypox-emia.Methods 66 patients with senile pneumonia accompanied by hypoxemia in Department of Respiratory of Nanchang 334 Hospital from Sep-tember 2020 to June 2021 were selected as the subjects,and they were divided into the control group and the observation group by random number ta-ble method,with 33 cases in each group.Both groups were received conventional treatment,the control group was received conventional nasal cathe-ter oxygen therapy,while the observation group was received HFNC,the respiratory rate,heart rate,arterial partial pressure of oxygen and oxygen saturation,comfort scores,respite time of dyspnea symptoms,length of hospital stay and incidence of mechanical ventilation were compared be-tween the two groups.Results 48 h after treatment,the respiratory rate and heart rate of the two groups were lower than those before treatment,the arterial partial pressure of oxygen and blood oxygen saturation were higher than those before treatment,and the respiratory rate and heart rate in the observation group were lower than those in the control group,the arterial partial pressure of oxygen and blood oxygen saturation were higher than those in the control group,the differences were statistically significant(P<0.05).After 2 and 48 h of treatment,the visual analogue scale(VAS)score in the observation group was lower than that at the previous time point,and the difference was statistically significant(P<0.05);there was no significant difference in VAS scores at each time point before and after treatment in the control group.Before treatment and after 2 h of treatment,there was no significant difference in VAS score between the two groups;after 48 h of treatment,the VAS score of the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The respite time of dyspnea symptom and the length of hospi-tal stay in the observation group were shorter than those in the control group,the incidence of mechanical ventilation was lower than that in control group,the differences were statistically significant(P<0.05).Conclusion HFNC can effectively improve the hypoxia state of patients with senile pneumonia accompanied by hypoxemia,improve comfort,accelerate the relief of dyspnea symptoms,and reduce the mechanical ventilation rate.