Objective:To analyze the curative effect of humidified high-flow nasal oxygen therapy combined with alveolar lavage in patients with severe pneumonia and respiratory failure.Methods:120 patients with severe pneumonia ...Objective:To analyze the curative effect of humidified high-flow nasal oxygen therapy combined with alveolar lavage in patients with severe pneumonia and respiratory failure.Methods:120 patients with severe pneumonia complicated with respiratory failure admitted to the Third People’s Hospital of Xining from July 2021 to December 2022 were randomly divided into two groups:group A and group B.The patients in group A were given humidified high-flow nasal oxygen therapy combined with alveolar lavage,whereas those in group B were given humidified high-flow nasal oxygen therapy.The treatment efficacy,blood gas analysis results,and differences in inflammatory mediators were compared between the two groups.Results:The curative effect in group A(96.67%)was significantly higher than that in group B(81.67%),P<0.05;the partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),oxygen saturation(SpO2),and Horowitz index(P/F)of group A were significantly better than group B,P<0.05;the interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α),and C-reactive protein(CRP)levels,white blood cell(WBC)count,serum procalcitonin(PCT),and neutrophil(N)percentage of group A were significantly lower than those of group B,P<0.05.Conclusion:For patients with severe pneumonia complicated with respiratory failure,alveolar lavage,on the basis of humidified high-flow oxygen therapy,can inhibit local inflammation,improve blood gas analysis results,promote disease recovery,and improve the clinical treatment effect。展开更多
目的探讨经鼻高流量氧气湿化治疗(HFNC)老年慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的可行性。方法选择2016年12月至2022年1月在北京大学首钢医院住院的老年AECOPD合并呼吸衰竭患者176例,HFNC组82例,无创正压通气(NPPV)组94例。...目的探讨经鼻高流量氧气湿化治疗(HFNC)老年慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的可行性。方法选择2016年12月至2022年1月在北京大学首钢医院住院的老年AECOPD合并呼吸衰竭患者176例,HFNC组82例,无创正压通气(NPPV)组94例。比较2组患者治疗后脉搏氧饱和度(SPO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、舒适度评分、出院率、气管插管率、转重症监护室(ICU)率及死亡率。计量资料以x^(ˉ)±s表示,2组间比较采用独立样本t检验;计数资料以例数或百分比表示,采用χ^(2)检验。结果HFNC组治疗30 min SPO_(2)、1 h SPO_(2)、6 h SPO_(2)均显著高于NPPV组(t=-2.049、-2.618、-3.314,P=0.043、0.010、0.001);出院前SPO_(2)显著低于NPPV组(t=2.162,P=0.033),但各时间点及出院前OI差异无统计学意义(P>0.05)。治疗6 h MAPHFNC组显著高于NPPV组(t=-2.209,P=0.029),但均在正常范围;治疗2天及3天HR HFNC组显著高于NPPV组(t=-2.199、-2.336,P=0.030、0.021);其余各时间点及出院前2组RR、HR、MAP均差异无统计学意义(P>0.05)。2组中PaCO_(2)差异无统计学意义(P>0.05)。HFNC组舒适度评分显著高于NPPV组(t=-46.807,P<0.001)。2组患者出院率、转ICU率、气管插管率及死亡率比较差异均无统计学意义(P>0.05)。结论HFNC治疗老年AECOPD合并Ⅰ型或轻度Ⅱ型呼吸衰竭患者疗效与NPPV相当,HFNC较NPPV舒适度更高。展开更多
目的 探讨经鼻高流量湿化氧疗在ICU患者撤机后的临床疗效.方法 计算机检索Cochrane图书馆,EMBASE、PubMed、Elsevier、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,收集关于经鼻高流量湿化氧疗的临床随机对照试验（RCT）....目的 探讨经鼻高流量湿化氧疗在ICU患者撤机后的临床疗效.方法 计算机检索Cochrane图书馆,EMBASE、PubMed、Elsevier、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,收集关于经鼻高流量湿化氧疗的临床随机对照试验（RCT）.由2名研究员按照纳入和排除标准筛选文献,评价纳入文献的质量并提取资料,使用RevMan5.3软件进行统计分析.结果 共纳入5篇RCT,982例研究对象.Meta分析结果显示,相比于传统吸氧方式,经鼻高流量湿化氧疗患者重插管率更低（OR=0.39,95% CI 0.25~0.62,P〈0.05）,氧合指数、舒适度、耐受性更优;而撤机后呼吸衰竭（OR=0.85,95% CI 0.35~2.09）、呼吸道感染（OR=0.69,95% CI 0.36~1.34）、ICU住院时间（MD=0.51,95% CI-0.02~1.03）、住院死亡率（OR=0.81,95% CI 0.39~1.69）等方面无明显优势（P〉0.05）.结论 ICU患者撤机后采用经鼻高流量湿化氧疗可降低ICU患者撤机后重插管率、提高氧合指数、舒适度和耐受性,但对降低ICU患者撤机后呼吸衰竭、呼吸道感染、ICU住院时间及死亡率无明显影响.展开更多
文摘Objective:To analyze the curative effect of humidified high-flow nasal oxygen therapy combined with alveolar lavage in patients with severe pneumonia and respiratory failure.Methods:120 patients with severe pneumonia complicated with respiratory failure admitted to the Third People’s Hospital of Xining from July 2021 to December 2022 were randomly divided into two groups:group A and group B.The patients in group A were given humidified high-flow nasal oxygen therapy combined with alveolar lavage,whereas those in group B were given humidified high-flow nasal oxygen therapy.The treatment efficacy,blood gas analysis results,and differences in inflammatory mediators were compared between the two groups.Results:The curative effect in group A(96.67%)was significantly higher than that in group B(81.67%),P<0.05;the partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),oxygen saturation(SpO2),and Horowitz index(P/F)of group A were significantly better than group B,P<0.05;the interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α),and C-reactive protein(CRP)levels,white blood cell(WBC)count,serum procalcitonin(PCT),and neutrophil(N)percentage of group A were significantly lower than those of group B,P<0.05.Conclusion:For patients with severe pneumonia complicated with respiratory failure,alveolar lavage,on the basis of humidified high-flow oxygen therapy,can inhibit local inflammation,improve blood gas analysis results,promote disease recovery,and improve the clinical treatment effect。
文摘目的探讨经鼻高流量氧气湿化治疗(HFNC)老年慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的可行性。方法选择2016年12月至2022年1月在北京大学首钢医院住院的老年AECOPD合并呼吸衰竭患者176例,HFNC组82例,无创正压通气(NPPV)组94例。比较2组患者治疗后脉搏氧饱和度(SPO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、舒适度评分、出院率、气管插管率、转重症监护室(ICU)率及死亡率。计量资料以x^(ˉ)±s表示,2组间比较采用独立样本t检验;计数资料以例数或百分比表示,采用χ^(2)检验。结果HFNC组治疗30 min SPO_(2)、1 h SPO_(2)、6 h SPO_(2)均显著高于NPPV组(t=-2.049、-2.618、-3.314,P=0.043、0.010、0.001);出院前SPO_(2)显著低于NPPV组(t=2.162,P=0.033),但各时间点及出院前OI差异无统计学意义(P>0.05)。治疗6 h MAPHFNC组显著高于NPPV组(t=-2.209,P=0.029),但均在正常范围;治疗2天及3天HR HFNC组显著高于NPPV组(t=-2.199、-2.336,P=0.030、0.021);其余各时间点及出院前2组RR、HR、MAP均差异无统计学意义(P>0.05)。2组中PaCO_(2)差异无统计学意义(P>0.05)。HFNC组舒适度评分显著高于NPPV组(t=-46.807,P<0.001)。2组患者出院率、转ICU率、气管插管率及死亡率比较差异均无统计学意义(P>0.05)。结论HFNC治疗老年AECOPD合并Ⅰ型或轻度Ⅱ型呼吸衰竭患者疗效与NPPV相当,HFNC较NPPV舒适度更高。
文摘目的 探讨经鼻高流量湿化氧疗在ICU患者撤机后的临床疗效.方法 计算机检索Cochrane图书馆,EMBASE、PubMed、Elsevier、中国期刊全文数据库、万方数据库和中国生物医学文献数据库,收集关于经鼻高流量湿化氧疗的临床随机对照试验（RCT）.由2名研究员按照纳入和排除标准筛选文献,评价纳入文献的质量并提取资料,使用RevMan5.3软件进行统计分析.结果 共纳入5篇RCT,982例研究对象.Meta分析结果显示,相比于传统吸氧方式,经鼻高流量湿化氧疗患者重插管率更低（OR=0.39,95% CI 0.25~0.62,P〈0.05）,氧合指数、舒适度、耐受性更优;而撤机后呼吸衰竭（OR=0.85,95% CI 0.35~2.09）、呼吸道感染（OR=0.69,95% CI 0.36~1.34）、ICU住院时间（MD=0.51,95% CI-0.02~1.03）、住院死亡率（OR=0.81,95% CI 0.39~1.69）等方面无明显优势（P〉0.05）.结论 ICU患者撤机后采用经鼻高流量湿化氧疗可降低ICU患者撤机后重插管率、提高氧合指数、舒适度和耐受性,但对降低ICU患者撤机后呼吸衰竭、呼吸道感染、ICU住院时间及死亡率无明显影响.
