无创机械通气对AECOPD合并呼吸衰竭患者睡眠质量、认知功能的影响

Effect of Noninvasive Mechanical Ventilation on Sleep Quality and Cognitive Function in Patients with AECOPD Complicated with Respiratory Failure

目的:分析无创机械通气对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者睡眠质量与认知功能的影响。方法:选取2022年8月至2024年2月泉州市第一医院G2呼吸与危重症医学科收治的AECOPD合并I型呼吸衰竭患者90例作为研究对象,按照随机数字表法分为对照组和观察组,每组45例。对照组采用经鼻导管高流量吸氧干预,观察组采用无创机械通气干预。比较2组患者干预前后的血气参数变化,包括动脉血氧分压(PO_(2))、二氧化碳分压(PCO_(2))与氧合指数(OI),采用匹兹堡睡眠质量指数(PSQI)比较2组患者干预前后睡眠质量的变化,采用蒙特利尔认知评估量表(MoCA)评估2组患者干预前后的认知功能。结果:干预后,观察组72 h动脉血氧分压(PO_(2))与氧合指数(OI)高于对照组,观察组PCO_(2)显著低于对照组,差异均有统计学意义(均P<0.05);干预后,观察组PSQI评分显著低于对照组,观察组MoCA评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论:无创机械通气可有效纠正AECOPD合并呼吸衰竭患者缺氧状态,改善认知功能与睡眠质量,值得临床推广应用。

Objective:To analyze the effects of non-invasive mechanical ventilation on sleep quality and cognitive function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods:A total of 90 patients with AECOPD combined with type I respiratory failure admitted to G2 Respiratory and Critical Care Medicine Department of Quanzhou First Hospital from August 2022 to February 2024 were selected as research objects,and were divided into control group and observation group according to random number table method,with 45 cases in each group.The control group was treated with high flow oxygen inhalation through nasal catheter,and the observation group was treated with non-invasive mechanical ventilation.Blood gas parameters of the two groups were compared before and after intervention,including partial pressure of arterial oxygen(PO_(2)),partial pressure of carbon dioxide(PCO_(2))and oxygenation index(OI).Pittsburgh Sleep Quality Index(PSQI)was used to compare the changes of sleep quality of the two groups before and after intervention.The cognitive function of the 2 groups before and after the intervention was assessed by the Montreal Cognitive Assessment Scale(MoCA).Results:After intervention,the 72 h arterial oxygen partial pressure(PO_(2))and oxygenation index(OI)of the observation group were higher than those of the control group,and the PCO_(2) of the observation group was significantly lower than that of the control group,with statistical significance(P<0.05).After the intervention,PSQI score of the observation group was significantly lower than that of the control group,and MoCA score of the observation group was significantly higher than that of the control group,with statistical significance between the two groups(P<0.05).Conclusion:Non-invasive mechanical ventilation can effectively correct the hypoxia state in patients with AECOPD complicated with respiratory failure,improve cognitive function and sleep quality,and is worthy of clinical application.