经鼻高流量氧疗联合无创机械通气治疗慢性阻塞性肺疾病急性加重期的临床效果

Clinical Efficacy of High-flow Nasal Cannula Oxygen Therapy Combined with Non-invasive Ventilation Treatment in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:探讨经鼻高流量氧疗(HFNC)联合无创机械通气(NIV)治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床效果。方法:选取2022年8月—2023年8月北京怀柔医院收治的100例AECOPD患者,以随机数字表法分成研究组与对照组,各50例。两组均给予常规治疗,对照组给予NIV治疗,研究组给予HFNC联合NIV治疗,比较两组临床疗效、生命体征、血气指标、炎症指标水平及并发症发生率。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组心率(HR)、呼吸频率(RR)均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组动脉血二氧化碳分压(PaCO_(2))均低于治疗前,血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))均高于治疗前,差异均有统计学意义(P<0.05),但两组间PaCO_(2)、SaO_(2)、PaO_(2)比较,差异均无统计学意义(P>0.05)。治疗后,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:HFNC联合NIV治疗应用于AECOPD,可提高临床疗效,改善生命体征与血气指标,缓解炎症反应,减少并发症。

Objective:To investigate the clinical effect of high-flow nasal cannula oxygen therapy(HFNC)combined with non-invasive ventilation(NIV)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:A total of 100 AECOPD patients admitted to Beijing Huairou Hospital from August 2022 to August 2023 were selected and divided into study group and control group by random number table method,with 50 cases in each group.Both groups were given conventional treatment,the control group was given NIV treatment,and the study group was given HFNC combined NIV treatment.The clinical efficacy,vital signs,blood gas indexes,inflammation indexes and complication rate of the two groups were compared.Result:The total effective rate of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,heart rate(HR)and respiratory rate(RR)in two groups were lower than those before treatment,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that before treatment,and the oxygen saturation(SaO_(2))and arterial partial pressure of oxygen(PaO_(2))were higher than those before treatment,the differences were statistically significant(P<0.05),but there were no statistically significant differences in PaCO_(2),SaO_(2) and PaO_(2) between the two groups(P>0.05).After treatment,interleukin-6(IL-6),C reactive protein(CRP)levels in both groups were lower than those before treatment,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The complication rate of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The combination of HFNC and NIV therapy in the treatment of AECOPD can improve clinical efficacy,improve vital signs and blood gas indicators,alleviate inflammatory reactions,and reduce complications.