[1]吕玉颖,曹志新,马玉平.无创通气间歇期经鼻高流量湿化氧疗治疗慢性阻塞性肺疾病急性加重临床效果及对患者气管插管率、血气指标的影响[J].陕西医学杂志,2024,(7):922-925,957.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.012]
　LYU Yuying,CAO Zhixin,MA Yuping.Therapeutic effect of high-flow nasal cannula oxygen therapy during intermittent period of noninvasive ventilation on AECOPD and its influence on tracheal intubation time and blood gas indicators[J].,2024,(7):922-925,957.[doi:DOI:10.3969/j.issn.1000-7377.2024.07.012]
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无创通气间歇期经鼻高流量湿化氧疗治疗慢性阻塞性肺疾病急性加重临床效果及对患者气管插管率、血气指标的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年7期
页码:
922-925,957
栏目:
临床研究
出版日期:
2024-07-05

文章信息/Info

Title:
Therapeutic effect of high-flow nasal cannula oxygen therapy during intermittent period of noninvasive ventilation on AECOPD and its influence on tracheal intubation time and blood gas indicators
作者:
吕玉颖; 曹志新; 马玉平
(首都医科大学附属北京朝阳医院呼吸与危重症医学科ICU,北京 100043)
Author(s):
LYU Yuying; CAO Zhixin; MA Yuping
(ICU of Department of Respiratory and Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)
关键词:
慢性阻塞性肺疾病急性加重;  无创通气间歇期;  经鼻高流量湿化氧疗;  气管插管;  血气指标;  不良反应
Keywords:
Acute exacerbation of chronic obstructive pulmonary disease;  Intermittent period of noninvasive ventilation;  High-flow nasal cannula oxygen therapy;  Tracheal intubation;  Blood gas indicator;  Adverse reactions
分类号:
R 563
DOI:
DOI:10.3969/j.issn.1000-7377.2024.07.012
文献标志码:
A
摘要:
目的:分析无创通气(NIV)间歇期经鼻高流量湿化氧疗(HFNC)治疗慢性阻塞性肺疾病急性加重(AECOPD)临床效果及对气管插管率、血气指标的影响。方法:回顾性收治的105例AECOPD患者资料,将患者分为对照组52例 [接受无创通气(NIV)治疗与常规氧疗]和观察组53例(接受NIV联合HFNC治疗),比较两组患者临床指标、血气指标、治疗失败原因及不良反应。结果:观察组呼吸支持时间、NIV间歇歇息次数、NIV每日平均使用时间、ICU住院时间均短(小)于对照组(均P<0.05),两组气管插管率比较差异无统计学意义(P>0.05); 治疗后两组动脉血氧分压(PaO2)比治疗前明显升高,动脉血二氧化碳分压(PaCO2)比治疗前明显降低(P<0.05),但两组治疗后PaO2、PaCO2水平比较差异无统计学意义(均P>0.05); 观察组患者呼吸困难加重率、治疗不耐受率均低于对照组(均P<0.05),两组CO2潴留加重率、低氧血症加重率比较差异无统计学意义(均P>0.05); 观察组不良反应发生率显著低于对照组(P<0.05)。结论:NIV间歇期给予HFNC治疗AECOPD患者对气管插管率及血气指标的影响与常规氧疗差异不显著,但可改善患者其他临床指标,减少治疗失败情况及不良反应。
Abstract:
Objective:To analyze the therapeutic effect of high-flow nasal cannula oxygen therapy(HFNC)during intermittent period of noninvasive ventilation(NIV)on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and the influence on tracheal intubation time and blood gas indicators.Methods:A total of 105 patients with AECOPD were reviewed.Using the random number table method,they were divided into the control group(52 patients treated with NIV and conventional oxygen therapy)and the observation group(53 patients treated with NIV and HFNC).The clinical indicators,blood gas indicators,causes of treatment failure,and adverse reactions were compared between the two groups.Results:The duration of respiratory support,rest times of NIV,average daily duration of NIV,and length of ICU stay in the observation group were shorter/lower than those in the control group(all P<0.05).There was no statistically significant difference in tracheal intubation rate between the two groups(P>0.05).After treatment,arterial partial pressure of oxygen(PaO2)increased significantly and arterial partial pressure ofcarbon dioxide(PaCO2)decreased significantly in both groups(all P<0.05),but there was no statistically significant differencebetweengroups(all P>0.05).The exacerbation rate of dyspnea and treatment intolerance rate in the observation group were lower than those in the control group(all P<0.05).There was no statistically significant difference in the exacerbation rate of CO2 retention or hypoxemia between the two groups(all P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:HFNC and conventional oxygen therapy applied during intermittent period of NIV have similar influence on tracheal intubation rate and blood gas indicators in patients with AECOPD.However,HFNC can improve other clinical indicators,and reduce treatment failure as well as adverse reactions.

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备注/Memo

备注/Memo:
基金项目:北京市科技计划任务书项目(Z201100005520032)
更新日期/Last Update: 2024-07-04