摘要
目的探讨无创机械通气后经鼻低流量氧疗对慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者的临床效果。方法该研究为回顾性研究。通过湖州市第一人民医院健康管理平台选择2021年1月至2023年3月于湖州市第一人民医院治疗的AECOPD合并Ⅱ型呼吸衰竭患者200例为研究对象。根据治疗方法分为两组,行无创机械通气后未行经鼻低流量氧疗的患者100例为对照组,行无创机械通气后经鼻低流量氧疗的患者100例为观察组。采用酶联免疫法(ELISA)测定两组抗炎因子[白细胞介素10(IL-10)、转化生长因子β(TGF-β)]以及促炎因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]的含量;比较两组治疗前后的血氧分压(PaO_(2))以及二氧化碳分压(PaCO_(2));比较两组患者发热、呼吸困难、心悸、咳嗽困难等症状的缓解消失时间。采用IBM SPSS 26.0软件进行统计学分析。结果治疗后对照组IL-10为(21.45±7.02)ng/L,低于观察组的(26.77±9.40)ng/L,差异有统计学意义(t=4.54,P<0.001),IL-6为(25.56±8.58)ng/L,高于观察组的(18.98±5.78)ng/L,差异有统计学意义(t=6.37,P<0.001);PaO_(2)为(71.41±5.91)mmHg(1 mmHg=0.133 kPa),低于观察组的(93.69±4.45)mmHg,差异有统计学意义(t=30.09,P=0.004),PaCO_(2)为(43.85±2.99)mmHg,高于观察组的(37.87±4.48)mmHg,差异有统计学意义(t=11.10,P<0.001);发热缓解时间为(6.59±1.51)d,长于观察组的(6.13±1.19)d,差异有统计学意义(t=2.39,P=0.008),呼吸困难缓解时间为(5.61±2.17)d,长于观察组的(4.47±1.73)d,差异有统计学意义(t=4.10,P=0.021)。结论无创机械通气后经鼻低流量氧疗对AECOPD合并Ⅱ型呼吸衰竭患者在炎症控制、症状缓解及肺功能恢复上可取得较好的治疗效果。
Objective To investigate the clinical efficacy of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated by type Ⅱ respiratory failure.Methods This study is a retrospective study.A total of 200 patients with AECOPD complicated by type Ⅱ respiratory failure who received treatment in The First People's Hospital of Huzhou from January 2021 to March 2023 were selected as the research subjects through the health management platform of The First People's Hospital of Huzhou.These patients were divided into a control group and an observation group(n=100 per group)according to the treatment methods.The control group received noninvasive mechanical ventilation but without transnasal low-flow oxygen therapy.The observation group received noninvasive mechanical ventilation and transnasal low-flow oxygen therapy.The anti-inflammatory factors(interleukin 10 and transforming growth factor-beta)and pro-inflammatory factors(tumor necrosis factor-alpha and interleukin 6)were measured by enzyme-linked immunosorbent assay in both groups.Oxygen pressure and carbon dioxide pressure were compared between the two groups before and after treatment.The relief and disappearance time of symptoms such as fever,difficulty in breathing,palpitations,and difficulty in coughing were compared between the two groups.Statistical analysis was performed using IBM SPSS 26.0 software.Results After treatment,the interleukin-10 level in the control group was(21.45±7.02)ng/L,which was significantly lower than(26.77±9.40)ng/L in the observation group(t=4.54,P<0.001).The interleukin-6 level in the control group was(25.56±8.58)ng/L,which was significantly higher than(18.98±5.78)ng/L in the observation group(t=6.37,P<0.001).Oxygen pressure in the control group was(71.41±5.91)mmHg(1 mmHg=0.133 kPa),which was significantly lower than(93.69±4.45)mmHg in the observation group(t=30.09,P=0.004).Carbon dioxide pressure in the control group
作者
诸小飞
凌莉
曹婷婷
Xiaofei Zhu;Li Ling;Tingting Cao(Department of Emergency,The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2023年第10期1529-1533,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
肺疾病
慢性阻塞性
急性病
呼吸
人工
无创通气
白细胞介素6
白细胞介素10
转化生长因子β
肿瘤坏死因子α
Pulmonary disease,chronic obstructive
Acute disease
Respiration,artificial
Noninvasive ventilation
Interleukin-6
Interleukin-10
Transforming growth factor beta
Tumor necrosis factor-alpha
