目的比较经鼻持续气道正压通气(NCPAP)、经鼻间歇正压通气(NIPPV)、经鼻加温湿化高流量氧疗(HFNC)在早产儿呼吸窘迫综合征(RDS)初始治疗中的应用效果。方法选择198例RDS的早产儿为研究对象,利用随机数字表法将患儿随机分为NCPAP组(n=65)...目的比较经鼻持续气道正压通气(NCPAP)、经鼻间歇正压通气(NIPPV)、经鼻加温湿化高流量氧疗(HFNC)在早产儿呼吸窘迫综合征(RDS)初始治疗中的应用效果。方法选择198例RDS的早产儿为研究对象,利用随机数字表法将患儿随机分为NCPAP组(n=65)、NIPPV组(n=61)和HFNC组(n=72),分别给予3种无创通气模式(NCPAP、NIPPV、HFNC)治疗。比较各组患儿使用无创通气呼吸支持后24 h血气分析pH值、动脉血二氧化碳分压(PaCO_(2))、呼吸指数(RI)、氧合指数(P/F)等参数,比较各组患儿吸入氧浓度(FiO_(2))、无创通气使用时间、不良反应及远期并发症等情况,通过多因素Logistic回归分析法探讨无创通气失败的相关因素。结果治疗前,3组患儿的血气分析pH值、PaCO_(2)值比较,差异均无统计学意义(均P>0.05);治疗后,3组患儿血气分析pH值差异无统计学意义(P>0.05),HFNC组患儿的血气分析PaCO_(2)水平明显高于NCPAP组和NIPPV组(均P<0.05)。HFNC组患儿的RI值、24 h FiO_(2)值明显高于NCPAP组和NIPPV组,P/F值低于NCPAP组和NIPPV组(均P<0.05)。NIPPV组患儿的P/F值高于NCPAP组,24 h FiO_(2)值低于NCPAP组(均P<0.05)。3组RDS患儿在无创通气持续时间、无创通气失败改有创通气率、相关并发症发生率方面比较,差异均无统计学意义(均P>0.05)。多因素Logistic回归分析结果显示,无创通气模式和RDS分级是无创通气失败的独立影响因素。结论NCPAP或NIPPV通气模式在治疗中提高早产儿RDS氧合、减少CO_(2)潴留等方面优于HFNC,通气模式的选择及RDS严重程度是无创通气治疗失败的独立影响因素。展开更多
BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important d...BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment.High flow nasal cannula(HFNC)oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state,reduces dead space ventilation and breathing effort,protects the loss of cilia in the airways,and improves patient comfort.AIM To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.METHODS Eighty AECOPD patients were included in the study.The patients were in the intensive care department of our hospital from October 2019 to October 2021.The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group.Differences in patient comfort,blood gas analysis and infection indices were analyzed between the two groups.RESULTS After treatment,symptoms including nasal,throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3rd and 5th days(P<0.05).Before treatment,the PaO_(2),PaO_(2)/FiO_(2),PaCO_(2),and SaO_(2)in the two groups of patients were not significantly different(P>0.05).After treatment,the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group(P<0.05).After treatment,the white blood cell count,and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group(P<0.05).CONCLUSION HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort,and reducing complications.HFNC is a clinically valuable technique for the treatment of AECOPD.展开更多
文摘目的比较经鼻持续气道正压通气(NCPAP)、经鼻间歇正压通气(NIPPV)、经鼻加温湿化高流量氧疗(HFNC)在早产儿呼吸窘迫综合征(RDS)初始治疗中的应用效果。方法选择198例RDS的早产儿为研究对象,利用随机数字表法将患儿随机分为NCPAP组(n=65)、NIPPV组(n=61)和HFNC组(n=72),分别给予3种无创通气模式(NCPAP、NIPPV、HFNC)治疗。比较各组患儿使用无创通气呼吸支持后24 h血气分析pH值、动脉血二氧化碳分压(PaCO_(2))、呼吸指数(RI)、氧合指数(P/F)等参数,比较各组患儿吸入氧浓度(FiO_(2))、无创通气使用时间、不良反应及远期并发症等情况,通过多因素Logistic回归分析法探讨无创通气失败的相关因素。结果治疗前,3组患儿的血气分析pH值、PaCO_(2)值比较,差异均无统计学意义(均P>0.05);治疗后,3组患儿血气分析pH值差异无统计学意义(P>0.05),HFNC组患儿的血气分析PaCO_(2)水平明显高于NCPAP组和NIPPV组(均P<0.05)。HFNC组患儿的RI值、24 h FiO_(2)值明显高于NCPAP组和NIPPV组,P/F值低于NCPAP组和NIPPV组(均P<0.05)。NIPPV组患儿的P/F值高于NCPAP组,24 h FiO_(2)值低于NCPAP组(均P<0.05)。3组RDS患儿在无创通气持续时间、无创通气失败改有创通气率、相关并发症发生率方面比较,差异均无统计学意义(均P>0.05)。多因素Logistic回归分析结果显示,无创通气模式和RDS分级是无创通气失败的独立影响因素。结论NCPAP或NIPPV通气模式在治疗中提高早产儿RDS氧合、减少CO_(2)潴留等方面优于HFNC,通气模式的选择及RDS严重程度是无创通气治疗失败的独立影响因素。
文摘BACKGROUND Most patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD)have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment.High flow nasal cannula(HFNC)oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state,reduces dead space ventilation and breathing effort,protects the loss of cilia in the airways,and improves patient comfort.AIM To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.METHODS Eighty AECOPD patients were included in the study.The patients were in the intensive care department of our hospital from October 2019 to October 2021.The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group.Differences in patient comfort,blood gas analysis and infection indices were analyzed between the two groups.RESULTS After treatment,symptoms including nasal,throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3rd and 5th days(P<0.05).Before treatment,the PaO_(2),PaO_(2)/FiO_(2),PaCO_(2),and SaO_(2)in the two groups of patients were not significantly different(P>0.05).After treatment,the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group(P<0.05).After treatment,the white blood cell count,and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group(P<0.05).CONCLUSION HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort,and reducing complications.HFNC is a clinically valuable technique for the treatment of AECOPD.
