无创呼吸机联合高流量氧疗治疗慢阻肺急性加重期合并呼吸衰竭患者疗效及对血清乳酸hs-CRP水平和血气指标的影响

doi:10.3969/j.issn.1006-6233.2022.11.017

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摘要 目的: 探究无创呼吸机联合高流量氧疗对慢阻肺急性加重期合并呼吸衰竭患者临床治疗效果。方法: 回顾性分析我院133例慢阻肺急性加重期合并呼吸衰竭患者资料,其中66例采用无创呼吸机辅助通气治疗为对照组,67例采用无创呼吸辅助通气及高流量氧疗治疗为联合组,比较两组疗效,治疗前后临床症状、血气指标及血清生化因子水平的变化情况及临床治疗指标。结果: 联合组临床疗效显著高于对照组(P<0.05);治疗后,两组临床症状均显著降低(P<0.05),SpO₂、PaO₂、OI、PH均显著升高(P<0.05),且联合组升高幅度显著高于对照组(P<0.05),PaCO₂、血清Lac、hs-CR、KL-6、Copeptin水平均显著降低,且联合组降低幅度显著高于对照组(P<0.05);联合组机械通气时间、ICU住院时间均显著低于对照组(P<0.05),间歇治疗时间显著高于对照组(P<0.05)。结论: 无创呼吸机联合高流量氧疗治疗慢阻肺急性加重期合并呼吸衰竭可显著改善临床症状,提高患者呼吸质量,降低机体炎症水平。

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关键词 ：慢阻肺急性加重期, 呼吸衰竭, 无创呼吸机, 高流量氧疗

Abstract：Objective: To explore the clinical effect of non-invasive ventilator combined with high flow oxygen therapy on patients with acute exacerbation of COPD complicated with respiratory failure.Methods: The data of 133 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and respiratory failure in the hospital were retrospectively analyzed. Among the patients, 66 cases treated with non-invasive ventilator-assisted ventilation were included in control group, and 67 cases given non-invasive ventilator-assisted ventilation and high-flow nasal cannula were enrolled as combined group. The efficacy, and clinical symptoms, blood gas indicators, serum biochemical factors and clinical treatment indicators before and after treatment were compared between the two groups. Results: The clinical efficacy of combined group was significantly higher than that of control group (P<0.05). The clinical symptoms of both groups after treatment were significantly reduced (P<0.05), and the SpO₂, PaO₂, OI and PH were increased significantly (P<0.05), and the increases of combined group were significantly higher than those of control group (P<0.05). The PaCO₂, serum Lac, hs-CR, KL-6 and Copeptin were significantly decreased, and the decreases of combined group were obviously higher than those of control group (P<0.05). The mechanical ventilation time and ICU stay of combined group were significantly shorter than those of control group (P<0.05), while the intermittent treatment time was significantly longer than that of control group (P<0.05). Conclusion: Non-invasive ventilator combined with high-flow nasal cannula in the treatment of acute exacerbation of COPD with respiratory failure can significantly improve the clinical symptoms, enhance the respiratory quality, and reduce the body’s inflammation.

Key words： Acute exacerbation of chronic obstructive pulmonary disease Respiratory failure Non-invasive ventilator High-flow nasal cannula

基金资助:四川省卫生健康委员会科研课题,(编号:19PJ284)

通讯作者: 吴仕平

引用本文:

邓波, 吴仕平, 杨兴, 刘丽, 雷洪军, 周忠惠. 无创呼吸机联合高流量氧疗治疗慢阻肺急性加重期合并呼吸衰竭患者疗效及对血清乳酸hs-CRP水平和血气指标的影响[J]. 河北医学, 2022, 28(11): 1845-1849.
DENG Bo, WU Shiping, YANG Xing, et al. Efficacy of Non-Invasive Ventilator Combined with High-Flow Nasal Cannula in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure and Its Influence on Serum Lactic Acid hs-CRP and Blood Gas Indicators. HeBei Med, 2022, 28(11): 1845-1849.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.11.017 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I11/1845

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