摘要
目的:探究经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者撤机效果的影响。方法:选取2015年1月~2017年1月于我院重症监护室接受治疗的慢性阻塞性肺疾病急性加重期撤机患者110例,按照随机数表法随机分为实验组与对照组,各55例。实验组行经鼻高流量氧疗的通气方法,对照组行无创正压通气的方法,记录并比较两组患者通气治疗前24h以及治疗后24h的PaCO_2、PaO_2、pH、心率、呼吸频率,以及治疗的舒适度、再次插管率、住ICU的天数、住院天数、死亡率等。结果:通气治疗后PaCO_2实验组为45.9±21.3mm Hg,对照组为49.6±18.9mm Hg;PaO_2实验组为85.6±12.4mm Hg,对照组为82.5±14.8mm Hg;经统计学分析,在治疗后两组患者的PaCO_2、PaO_2具有统计学差异。pH值实验组为7.40±0.05,对照组为7.42±0.07;心率实验组为89.2±15.8次/min,对照组为88.9±13.4次/min;呼吸频率实验组为21.4±5.3次/min,对照组为22.1±4.9次/min;经统计学分析,在治疗后两组患者的pH、心率、呼吸频率无明显的统计学差异。舒适度实验组感到轻、中度不适的患者为4例,重度、极重度不适患者为8人;而对照组感到轻、中度不适的患者为25人,重度、极重度不适患者为30人;两组比较,差异具有统计学意义。再次插管率实验组为3.6%(2例),对照组为18.2%(10例);住ICU的天数实验组为9.7±3.1天,对照组12.5±4.2天;住院天数实验组为24.6±3.8天,对照组29.3±4.5天;死亡率实验组1.8%(1例),对照组9.1%(5天);经统计学分析,在治疗后两组患者的再次插管率、住ICU的天数、住院天数、死亡率具有统计学差异。结论:经鼻高流量氧疗能够提升AECOPD撤机患者的PaO_2、降低PaCO_2,并且能够提高患者的舒适度,减少再次插管率、住ICU的天数、住院天数、死亡率。
Objective To investigate the nasal high flow oxygen therapy on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients weaning effect. Methods 110 cases of weaning period were selected from January 2015 to January 2017 in our hospital intensive care unit for treatment of acute exacerbation of chronic obstructive pulmonary disease were selected, according to the random number table method were randomly divided into experimental group and control group, 55 cases in each. The experimental group underwent nasal ventilation method for high flow oxygen therapy, the control group underwent noninvasive method airway pressure, the two groups were recorded and compared 24 h and PaCO_2 ventilation before treatment, after treatment of 24 h PaO_2, pH, heart rate, respiratory rate, treatment and comfort, reintubation rate, ICU days, days of hospitalization and mortality. Results After ventilation PaCO_2 in experimental group was 45.9±21.3 mm Hg, the control group was 49.6±18.9 mm Hg; PaO_2 in the experimental group was 85.6±12.4 mm Hg, the control group was 82.5±14.8 mm Hg; statistical analysis, two groups of patients in PaCO_2 after weaning, PaO_2 has obvious difference. The pH value of experimental group was 7.40±0.05, the control group is 7.42±0.07; heart rate of experimental group was 89.2±15.8/min, the control group is 88.9±13.4/min; respiratory rate of experimental group was 21.4±5.3/min, the control group is 22.1±4.9/min; the statistical analysis, two groups in pH. The heart rate of patients after weaning, there is no obvious difference between the frequency of respiration. Comfort of the experimental group was light, moderate discomfort of the patients was 47, severe, very severe discomfort in 8 patients; while the control group was mild, moderate discomfort in patients with 25, severe, very severe discomfort in 30 patients; the two groups, the difference was statistically obvious. Reintubation rate was 3.6% in the experimental group(2 people), the control group was 18.2%(10 days); the ex
出处
《湖南师范大学学报（医学版）》
2018年第1期145-148,共4页
Journal of Hunan Normal University(Medical Sciences)
