两种氧疗方式治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的效果

Effect of two oxygen therapy methods in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure

  • 摘要:
      目的  探讨经鼻高流量氧疗(HFNC)和传统鼻导管氧疗在慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者中的临床疗效。
      方法  将75例AECOPD合并Ⅱ型呼吸衰竭患者分为对照组(n=36)和实验组(n=39)。对照组在常规治疗基础上给予传统鼻导管氧疗,实验组在常规治疗基础上给予HFNC。比较2组的动脉血氧分压pa(O2)、动脉血二氧化碳分压pa(CO2)、血氧饱和度(SpO2)、呼吸频率、心率、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、痰液黏稠度、痰量的变化。
      结果  治疗后,实验组pa(CO2)、呼吸频率、心率、痰液黏稠度、痰量改善程度与对照组比较,差异有统计学意义(P< 0.05)。
      结论  HFNC对AECOPD合并Ⅱ型呼吸衰竭患者的治疗效果优于传统鼻导管氧疗,可有效提高通气效率,降低呼吸频率,减少二氧化碳重复吸入。

     

    Abstract:
      Objective  To investigate the clinical efficacy of high-flow nasal canula (HFNC) and conventional nasal catheter oxygen therapy in patients with acute exacerbation of chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure.
      Methods  Seventy-five patients with AECOPD combined with type Ⅱ respiratory failure were divided into the control group (n=36) and the experimental group (n=39). The control group was given conventional nasal catheter oxygen therapy on the basis of conventional treatment, while the experimental group was given HFNC on the basis of conventional treatment. The changes of arterial oxygen partial pressure pa(O2), arterial carbon dioxide partial pressure pa(CO2), oxygen saturation (SpO2), respiratory frequency, heart rate, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), sputum viscosity, and sputum volume were compared in the two groups.
      Results  After treatment, the improvement of pa(CO2), respiration rate, heart rate, sputum viscosity and sputum volume in the experimental group showed significant difference compared with those in the control group (P< 0.05).
      Conclusion  HFNC is superior to traditional nasal catheter oxygen therapy in the treatment of patients with AECOPD combined with type Ⅱ respiratory failure, which can effectively improve the ventilation efficiency, decrease the respiratory rate, and reduce the repeated inhalation of carbon dioxide.

     

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