经鼻高流量氧气湿化疗法在慢性阻塞性肺疾病呼吸衰竭患者中的应用分析

doi:10.3969/j.issn.1006-6233.2022.01.024

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摘要 目的:分析经鼻高流量氧气湿化疗法(HFNC)在慢性阻塞性肺疾病(COPD)呼吸衰竭患者中的应用效果。方法:选取2019年1月至2021年1月期间我院接收治疗的158例COPD呼吸衰竭患者为研究对象,将其简单随机分组,分为A组和B组,各79例。A组给予经鼻低流量氧气吸入治疗,B组给予HFNC治疗。比较两组治疗前1d和治疗后1d的氧代谢、呼吸、血气分析、肺功能情况,并比较两组治疗后的临床疗效和治疗中的不良反应。结果:治疗前两组的氧代谢、呼吸、血气分析、肺功能情况比较差异统计学无意义(P>0.05);治疗后较治疗前两组的VO₂、呼吸频率、气道峰值、气道阻力、PaCO₂水平均降低,两组的CaO₂、DO₂、SaO₂、PaCO₂、FEV1、FVC、PEER水平均升高,且B组各指标的变化幅度较高,差异统计学有意义(P<0.05)。A组和B组的临床总有效率分别为78.48%和94.93%,B组高于A组,差异统计学有意义(P<0.05)。A组鼻出血、鼻干燥、口干的发生率均高于B组,差异统计学有意义(P<0.05)。结论:与传统经鼻低流量氧气吸入治疗相比,HFNC治疗COPD呼吸衰竭能够有效改善氧代谢、呼吸、血气和肺功能,改善临床疗效,减少不良反应。

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	李霞
	魏青梅
	陈建峰

关键词 ：慢性阻塞性肺疾病, 呼吸衰竭, 经鼻低流量氧气吸入, 经鼻高流量氧气湿化疗法, 疗效

Abstract：Objective: To analyze the application effect of nasal high flow oxygen humidification therapy (hfnc) in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. Methods: The 158 patients with COPD respiratory failure who were treated in our hospital from January 2019 to January 2021 were selected as the research subjects, and they were simply randomly divided into group A and group B, with 79 cases in each group. Group A was treated with low flow oxygen inhalation through nose, and group B was treated with HFNC. The oxygen metabolism, respiration, blood gas analysis and lung function of the two groups before and after treatment were compared, and the clinical efficacy and adverse reactions of the two groups after treatment were compared. Results: There was no significant difference in oxygen metabolism, respiration, blood gas analysis, and lung function between the two groups before treatment (P>0.05); after treatment, compared with before treatment, the levels of VO₂, respiratory frequency, peak airway resistance, airway resistance, PaO₂ were decreased, the levels of CaO₂, DO₂, SaO₂, PaCO₂, FEV1, FVC, PEER were increased in the two groups, and the changes in the indexes of group B were higher, and the difference was significant (P<0.05). The clinical total effective rates of group A and group B were 78.48% and 94.93% respectively, and the difference was significant (P< 0.05). The incidences of epistaxis, dry nose and dry mouth in group A were higher than those in group B (P< 0.05). Conclusion: Compared with traditional nasal low flow oxygen inhalation therapy, HFNC can effectively improve oxygen metabolism, respiration, blood gas and lung function, improve clinical efficacy and reduce adverse reactions in the treatment of COPD with respiratory failure.

Key words： Chronic obstructive pulmonary disease Respiratory failure Low flow oxygen inhalation through nose Nasal high flow oxygen humidification therapy Curative effect

基金资助:山西省卫计委科研课题计划项目,(编号:201602028)

引用本文:

李霞, 魏青梅, 陈建峰. 经鼻高流量氧气湿化疗法在慢性阻塞性肺疾病呼吸衰竭患者中的应用分析[J]. 河北医学, 2022, 28(1): 117-121.
LI Xia, WEI Qingmei, CHEN Jianfeng. Application Analysis of Nasal High Flow Oxygen Humidification Therapy in Patients with Chronic Obstructive Pulmonary Disease and Respiratory Failure. HeBei Med, 2022, 28(1): 117-121.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.01.024 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I1/117

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