高流量湿化氧疗联合甲泼尼龙琥珀酸钠对慢性阻塞性肺疾病合并呼衰患者疗效的影响

Efficacy of HFNC combined with methylprednisolone sodium succinate in patients with COPD combined with expiratory failure

目的:探讨高流量湿化氧疗(HFNC)联合张家口市第一医院慢性阻塞性肺疾病(COPD)合并呼衰患者疗效的影响。方法:选取自2018年11月至2022年5月我院108例COPD合并Ⅰ型呼衰患者,根据治疗方式差异分为两组,其中研究组56例,采用机械通气联合HFNC及甲泼尼龙琥珀酸钠治疗,而对照组52例,则采用机械通气治疗,比较2组患者的疗效等差异。结果:临床的总有效率方面,术后研究组(98.2%)相较对照组(75.0%)更高(P<0.05);治疗后两组的PaO_(2)及OⅠ均较治疗前升高,而PaCO_(2)均较治疗前降低,且研究组更甚(P<0.05);治疗后两组的肺功能相关指标均较治疗前有所改善,且研究组更甚(P<0.05);治疗后两组的呼吸情况均较治疗前好转,且研究组更甚(P<0.05);治疗后两组的血清相关指标均较治疗前降低,且研究组更甚(P<0.05);总生存率方面,术后研究组(91.1%)相较于对照组(76.9%)更高(P<0.05)。结论:HFNC联合甲泼尼龙琥珀酸钠对COPD合并呼衰患者的疗效更佳,不仅可改善其肺功能情况,同时还可减轻炎症反应程度,最终改善预后,值得临床推广应用。

Objective:To explore the efficacy of HFNC combined with methylprednisolone sodium succinate in patients with COPD combined with expiratory failure and the impact on their mMRC scores and so on.Methods:108 patients with COPD combined with type Ⅰ expiratory failure in our hospital were selected from November 2018 to May 2022,and were divided into two groups according to the difference in treatment modalities,of which,56 cases in the study group were treated with mechanical ventilation combined with HFNC and methylprednisolone sodium succinate,whereas 52 cases in the control group were treated with mechanical ventilation,and the differences in the therapeutic efficacy and other differences in the patients of the 2 groups were compared.Results:The overall clinical efficiency rate of study group(98.2%)was obvious higher than that of control group(75.0%)(P<0.05).The PaO_(2) and OⅠ of the two groups were higher than that before treatment,and the PaCO_(2) was lower than that before treatment,and it was more significant in the study group(P<0.05).The indicators related to the lung function of the two groups were better than that before treatment,and it was more significant in the study group(P<0.05).The respiratory conditions of both groups after treatment were better than before treatment,and more so in the study group(P<0.05).The serum-related indexes of both groups after treatment were lower than before treatment,and more so in the study group(P<0.05).The overall survival rate of study group after surgery(91.1%)was obvious higher than control group(76.9%)(P<0.05).Conclusion:HFNC combined with methylprednisolone sodium succinate has better efficacy in patients with COPD combined with expiratory failure,which not only improves their lung function,but also reduces the degree of inflammatory response,and ultimately improves the prognosis,which is worthy of clinical promotion and application.