有创机械通气-高流量氧疗序贯治疗重症肺炎合并重度呼吸衰竭患者的效果

Effects of invasive mechanical ventilation-high flow oxygen therapy sequential therapy on patients with severe pneumonia complicated with severe respiratory failure

目的:观察有创机械通气-高流量氧疗序贯治疗重症肺炎合并重度呼吸衰竭患者的效果。方法:选取2019—2022年该院收治的70例重症肺炎合并重度呼吸衰竭患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各35例。两组均予以对症治疗,在此基础上,对照组采用有创-无创机械通气序贯治疗,研究组采用有创机械通气-高流量氧疗序贯治疗。比较两组治疗前后血气分析指标[pH值、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)]水平、呼吸困难(Borg呼吸困难评分量表)评分、ICU入住时间,28d病死率,以及并发症发生率。结果:治疗后,研究组pH值、OI水平均高于对照组,PaCO_(2)水平低于对照组,差异有统计学意义(P<0.05);治疗后,研究组Borg呼吸困难评分低于对照组,差异有统计学意义(P<0.05);两组ICU入住时间、28d病死率和并发症发生率比较,差异均无统计学意义(P>0.05)。结论:有创机械通气-高流量氧疗序贯治疗重症肺炎合并重度呼吸衰竭患者可改善血气分析指标水平,降低呼吸困难评分,效果优于有创-无创机械通气序贯治疗。

Objective:To observe effects of invasive mechanical ventilation-high flow oxygen therapy sequential therapy on patients with severe pneumonia complicated with severe respiratory failure.Methods:A prospective study was conducted on 70 patients with severe pneumonia complicated with severe respiratory failure admitted to the hospital from 2019 to 2022.According to the random number table method,they were divided into study group and control group,35 cases in each group.Both groups were given symptomatic treatment.On this basis,the control group was treated with invasive-noninvasive mechanical ventilation sequential therapy,while the study group was treated with invasive mechanical ventilation-high flow oxygen therapy sequential therapy.The levels of blood gas analysis indexes[pH value,arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(OI)],the dyspnea(Borg dyspnea score scale)score,the ICU stay time,the 28-day mortality,and the complication rate were compared between the two groups before and after the treatment.Results:After the treatment,the pH value and OI level of the study group were higher than those of the control group,the PaCO_(2) level was lower than that of the control group,and the differences were statistically significant(P<0.05).After the treatment,the Borg dyspnea score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).However,there were no significant differences in the ICU stay time,the 28-day mortality and the complication rate between the two groups(P>0.05).Conclusions:Invasive mechanical ventilation-high flow oxygen therapy sequential therapy can improve the levels of blood gas analysis indexes the and reduce dyspnea scores in the patients with severe pneumonia complicated with severe respiratory failure.Moreover,it is superior to invasive-noninvasive mechanical ventilation sequential therapy.