经鼻高流量湿化氧疗在慢阻肺急性加重期伴呼吸衰竭患者治疗中的应用效果

Application of High-flow Nasal Cannula Oxygen Therapy in the Treatment of COPD with Respiratory Failure During Acute Exacerbation

目的分析经鼻高流量湿化氧疗(High-flow Nasal Cannula Oxygen Therapy,HFNC)在慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)伴呼吸衰竭(Respiratory Failure,RF)患者中的效果。方法选取2021年5月—2023年5月毕节市中医医院收治的98例AECOPD伴RF患者,按随机数表法分成两组,各49例。对照组行无创正压通气(Noninvasive Positive Pressureventilation,NPPV),观察组行经鼻高流量湿化氧疗。对比两组治疗效果。结果观察组治疗总有效率为93.88%,高于对照组的79.59%,不良反应发生率为4.08%,低于对照组的16.33%,差异有统计学意义(χ^(2)=4.346、4.009,P均<0.05);治疗前,两组二氧化碳分压、血氧分压、C反应蛋白、白细胞介素-6、用力肺活量、呼气流量峰值相比,差异无统计学意义(P均>0.05);治疗后,观察组二氧化碳分压、C反应蛋白、白细胞介素-6低于对照组,血氧分压、用力肺活量、呼气流量峰值高于对照组,差异有统计学意义(P均<0.05)。结论HFNC能够改善AECOPD伴RF患者的动脉血气水平,控制机体炎症反应,促进肺功能恢复,且不良反应少。

Objective To investigate the effects of high-flow nasal cannula oxygen therapy(HFNC)in patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)with respiratory failure(RF).Methods A total of 98 patients with AECOPD and RF admitted to Bijie Hospital of Traditional Chinese Medicine from May 2021 to May 2023 were selected and divided into two groups according to random number table method,with forty-nine in cases each group.The control group was treated with noninvasive positive pressureventilation(NPPV),and the observation group was treated with nasal high-flow nasal cannula oxygen therapy.The therapeutic effect of the two groups was compared.Results The total effective rate of the observation group was 93.88%,higher than that of the control group 79.59%,and the incidence of adverse reactions was 4.08%,lower than that of the control group 16.33%,and the dif-ferences were statistically significant(χ^(2)=4.346,4.009,both P<0.05).Before treatment,the peaks of carbon dioxide partial pressure,blood oxygen partial pressure,C-reactive protein,interleukin-6,forced vital capacity and expiratory flow in the two group were compared,and the differences were not statistically significant(all P>0.05).After treat-ment,the partial pressure of carbon dioxide,C-reactive protein and interleukin-6 in observation group were lower than those in control group,while the peak value of blood oxygen partial pressure,forced vital capacity and expiratory flow in observation group were higher than those in control group,and the differences were statistically significant(all P<0.05).Conclusion HFNC can improve arterial blood gas level in patients with AECOPD and RF,control the inflam-matory response of the body,and promote the recovery of lung function with less adverse reactions.