摘要
目的比较经鼻高流量氧疗(HFNC)与无创通气(NIV)对慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的治疗效果。方法选择100例AECOPD合并呼吸衰竭患者进行研究,随机分为观察组和对照组,每组50例。观察组予HFNC治疗,对照组予NIV治疗,比较两组患者的一般资料、APACHEⅡ评分,比较两组治疗前、治疗2 h后、治疗24 h后的pH值、动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、氧合指数(OI、PaO_(2)/FiO_(2))变化,比较两组治疗后的转归、治疗失败率及并发症。结果观察组与对照组患者的APACHEⅡ评分分别为(17.4±4.0)分、(16.6±3.6)分,差异无统计学意义(P>0.05)。治疗2 h后,两组的pH值、PaO_(2)、PaCO_(2)均差异无统计学意义(P>0.05)。治疗24 h后,观察组PaO_(2)和OI明显高于对照组(P0.05)。两组在气管插管率、转变通气方式、放弃或死亡转归的比较差异无统计学意义(P>0.05)。观察组不耐受发生率明显低于对照组(P0.05)。结论对AECOPD合并呼吸衰竭的患者,HFNC与NIV对比,具有相似的治疗效果,HFNC在改善氧合效果更显著,治疗耐受性更好,并发症少,成为AECOPD合并呼吸衰竭的另一通气方式。
Objective To compare the effects of high-flow nasal cannula(HFNC)oxygen therapy and non-invasive ventilation(NIV)on AECOPD combined with respiratory failure.Methods A total of 100 patients with AECOPD and respiratory failure,who were admitted to our hospital from July 2018 to October 2019,were selected for the study.They were randomly divided into treatment group and control group(n=50).The treatment group was treated with HFNC,and the control group was treated with NIV.The general information and APACHEⅡscore between the two groups were compared,so were the changes in pH,PaO_(2),PaCO_(2),and OI before and 2 hours and 24 hours after treatment.Results The APACHEⅡscores of the treatment group and control group were 17.4±4.0 and 16.6±3.6,respectively(P>0.05).After 2 hours of treatment,there was no significant difference in the pH value,PaO_(2),PaCO_(2)between the two groups(P>0.05).After 24 hours of treatment,the PaO_(2)and OI were significantly higher in the treatment group than those in the control group(P0.05).There was no significant difference in the comparison of tracheal intubation rates,changed ventilation modes,abandoned or death outcomes(P>0.05).The incidence of intolerance was significantly lower in the treatment group than in the control group(P<0.05).Conclusions For patients with AECOPD and respiratory failure,HFNC has a similar therapeutic effect compared with NIV.HFNC is more effective in improving oxygenation,has better treatment tolerance and fewer complications.
作者
卢健聪
邱惠中
陈丽丽
LU Jian-cong;QIU Hui-zhong;CHEN Li-li(Department of Respiratory Diseasesy Huizhou Municipal Central Hospital,Huizhou 516001,Guangdongy China;不详)
出处
《广东医学》
CAS
2021年第3期274-278,共5页
Guangdong Medical Journal
基金
惠州市科技计划项目(20170401)。
关键词
经鼻高流量氧疗
无创通气
慢性阻塞性肺疾病
呼吸衰竭
high flow nasal cannula
non-invasive ventilation
chronic obstructive pulmonary disease
respiratory failure
