摘要
目的探究有创机械通气与经鼻高流量氧气湿化序贯疗法治疗老年重症肺炎伴呼吸衰竭患者的效果及对血气分析指标、高迁移率族蛋白B1(HMGB1)、白细胞介素-17(IL-17)的影响。方法选取2021年1月至2022年1月我院收治的150例老年重症肺炎伴呼吸衰竭患者为研究对象,按照治疗方法将其分为对照组与观察组,各75例。对照组采用有创机械通气治疗,观察组采用经鼻高流量氧气湿化序贯疗法。比较两组的治疗效果。结果观察组的机械通气时间、呼吸重症监护室(RICU)入住时间短于对照组,再插管率、呼吸机相关性肺炎(VAP)发生率低于对照组(P<0.05)。治疗后,观察组的二氧化碳分压(PaCO_(2))低于对照组,氧分压(PaO_(2))、血氧饱和度(SaO_(2))高于对照组(P<0.05)。治疗后,观察组的HMGB1、IL-17水平低于对照组(P<0.05)。治疗后,观察组的用力呼气量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC高于对照组(P<0.05)。结论经鼻高流量氧气湿化序贯疗法较有创机械通气治疗老年重症肺炎伴呼吸衰竭患者的效果更好,不仅能够有效改善血气分析指标,还能调节HMGB1、IL-17水平,促进肺功能恢复。
Objective To explore the effect of invasive mechanical ventilation and nasal high-flow oxygen humidification sequential therapy in the treatment of elderly patients with severe pneumonia with respiratory failure and its influences on blood gas analysis indexes,high mobility group box 1 protein(HMGB1)and interleukin-17(IL-17).Methods A total of 150 elderly patients with severe pneumonia with respiratory failure admitted in our hospital from January 2021 to January 2022 were selected as the research objects,the patients were divided into control group and observation group according to the treatment methods,with 75 cases in each group.The control group was treated with invasive mechanical ventilation,and the observation group was treated with nasal high-flow oxygen humidification sequential therapy.The therapeutic effects of the two groups were compared.Results The mechanical ventilation time and respiratory intensive care unit(RICU)stay time in the observation group were shorter than those in the control group,and the reintubation rate and the incidence of ventilator associated pneumonia(VAP)were lower than those in the control group(P<0.05).After treatment,the partial pressure of carbon dioxide(PaCO_(2))in the observation group was lower than that in the control group,and the pressure of oxygen(PaO2)and oxygen saturation(SaO_(2))were higher than those in the control group(P<0.05).After treatment,the levels of HMGB1 and IL-17 in the observation group were lower than those in the control group(P<0.05).After treatment,the forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))and FEV_(1)/FVC in the observation group were higher than those in the control group(P<0.05).Conclusion The nasal high-flow oxygen humidification sequential therapy is more effective than invasive mechanical ventilation in the treatment of elderly patients with severe pneumonia with respiratory failure.It can not only effectively improve the blood gas analysis indexes,but also regulate the levels of HMGB1 and IL-17,and promot
作者
丁帅
冯博琳
DING Shuai;FENG Bolin(Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University,Yulin 719000,China)
出处
《临床医学研究与实践》
2024年第5期67-70,75,共5页
Clinical Research and Practice
关键词
有创机械通气
经鼻高流量氧气湿化序贯疗法
老年
重症肺炎
呼吸衰竭
血气分析
invasive mechanical ventilation
nasal high-flow oxygen humidification sequential therapy
elderly
severe pneumonia
respiratory failure
blood gas analysis
