经鼻高流量加温加湿吸氧对COPD急性加重期患者动脉血气及生命体征的影响

The Effect of Nasal High-Flow Heated Humidified Oxygen Therapy on Arterial Blood Gas and Vital Signs in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease(COPD)

目的分析经鼻高流量加温加湿吸氧对慢性阻塞性肺疾病急性加重期(AECOPD)患者动脉血气及生命体征的影响。方法选取2019年6月至2021年5月河南省范县人民医院接收的104例COPD急性加重期患者作为此次研究对象,并将2019年6月至2020年5月收治患者分为常规组,而2020年6月至2021年5月为HFNC组,均为52例。常规组予以传统鼻导管氧疗方案氧疗,HFNC组予以经鼻高流量(HFNC)方案氧疗,比较两组血气功能[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]、呼吸功能[呼吸频率(RR)、心率(HR)、平均动脉压(MAP)]、痰液粘稠度。结果两组干预24 h及干预72 h的PaO_(2)及PaO_(2)/FiO_(2)较干预前上升,且干预72 h上升更为显著,差异有统计学意义(P<0.05),两组干预24 h及干预72 h的PaCO_(2)较干预前下降,且干预72 h下降更为显著,差异有统计学意义(P<0.05);HFNC组干预72 h的PaO_(2)及PaO_(2)/FiO_(2)均较常规组上升更为显著,干预72 h的PaCO_(2)较常规组下降更为显著,差异有统计学意义(P<0.05)。两组干预24 h及干预72 h的HR、RR及MAP均较干预前下降,且干预72 h下降更为显著,差异有统计学意义(P<0.05);HFNC组干预72 h的HR、RR及MAP均较常规组下降更为显著,差异有统计学意义(P<0.05)。干预后,两组痰液粘稠Ⅲ级较干预前显著减少,且HFNC组改善情况优于常规组,差异有统计学意义差异有统计学意义(P<0.05)。结论HFNC较传统氧疗手段于COPD急性加重期患者而言,可更稳定血气功能及生命体征,降低患者痰液粘稠度,提高满意度及舒适度,值得应用于临床。

Objective To analyze the effect of nasal high-flow heated humidified oxygen therapy on arterial blood gas and vital signs in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 104 patients with acute exacerbation of COPD admitted to Fan County People’s Hospital from June 2019 to May 2021 were selected as the research subjects.Patients admitted from June 2019 to May 2020 were divided into the conventional group,and those from June 2020 to May 2021 were the HFNC group,each with 52 cases.The conventional group was given traditional nasal cannula oxygen therapy,and the HFNC group was given nasal high-flow(HFNC)oxygen therapy.The blood gas function[arterial oxygen pressure(PaO_(2)),arterial carbon dioxide pressure(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2))],respiratory function[respiratory rate(RR),heart rate(HR),mean arterial pressure(MAP)],and sputum viscosity were compared between the two groups.Results The PaO_(2) and PaO_(2)/FiO_(2) of the two groups increased 24 h and 72 h after intervention compared with before intervention,and the increase at 72 h was more significant,with a statistically significant difference(P<0.05).The PaCO_(2) of the two groups decreased 24 h and 72 h after intervention compared with before intervention,and the decrease at 72 h was more significant,with a statistically significant difference(P<0.05).The PaO_(2) and PaO_(2)/FiO_(2) of the HFNC group were significantly higher than those of the conventional group at 72 h after intervention,and the PaCO_(2) was significantly lower than that of the conventional group,with a statistically significant difference(P<0.05).The HR,RR,and MAP of the two groups decreased 24 h and 72 h after intervention compared with before intervention,and the decrease at 72 h was more significant,with a statistically significant difference(P<0.05).The HR,RR,and MAP of the HFNC group were significantly lower than those of the conventional group at 72 h after intervention,with a statistically significant difference(P<0.05).After intervention,the level III sputum viscosity of the two groups significantly decreased compared with before intervention,and the improvement of the HFNC group was better than that of the conventional group,with a statistically significant difference(P<0.05).Conclusion Compared with traditional oxygen therapy,HFNC can stabilize blood gas function and vital signs in patients with acute exacerbation of COPD,reduce patient’s sputum viscosity,improve satisfaction and comfort,and is worth applying in clinical practice.