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[1]杨明福,王永兴.HFNC与NPPV在AECOPD伴Ⅱ型呼吸衰竭中的疗效分析[J].中华肺部疾病杂志,2023,(06):804-808.[doi:10.3877/cma.j.issn.1674-6902.2023.06.012]
　Yang Mingfu,Wang Yongxing..Curative effect comparison between HFNC and NPPV in patients with AECOPD complicated with type Ⅱ respiratory failure[J].,2023,(06):804-808.[doi:10.3877/cma.j.issn.1674-6902.2023.06.012]
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HFNC与NPPV在AECOPD伴Ⅱ型呼吸衰竭中的疗效分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2023年06期
页码:
804-808
栏目:
论著
出版日期:
2023-12-20

文章信息/Info

Title:
Curative effect comparison between HFNC and NPPV in patients with AECOPD complicated with type Ⅱ respiratory failure
作者:
杨明福; 王永兴
710054 西安,空军军医大学空军第986医院重症医学科
Author(s):
Yang Mingfu;  Wang Yongxing.
Department of Critical Medicine, 986th Hospital of Air Force, Air Force Medical University, Xi'an 710054, China
关键词:
急性加重期; 肺疾病; 慢性阻塞性;  Ⅱ型呼吸衰竭;  经鼻高流量氧疗;  无创正压通气;  二氧化碳潴留;  耐受性
Keywords:
Acute exacerbation of chronic obstructive pulmonary disease;  Type Ⅱ respiratory failure;  High-flow nasal cannula oxygen therapy;  Non-invasive positive pressure ventilation;  Carbon dioxide retention;  tolerance
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2023.06.012
摘要:
目的 分析经鼻高流量湿化氧疗(high-flow nasal cannula oxygen therapy, HFNC)与无创正压通气(non-invasive positive pressure ventilation, NPPV)对慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)伴Ⅱ型呼吸衰竭的疗效。方法 选取2020年1月至2023年6月我院收治的AECOPD伴Ⅱ型呼吸衰竭患者37例为对象,随机分成观察组17例与对照组20例。观察组采用HFNC,对照组采用NPPV。对比治疗24 h、出院时的APACHE Ⅱ评分、血气分析及心率、呼吸频率、氧饱和度指标,比较住院治疗过程中气道管理干预次数、氧疗累计时间及疗效不佳。结果 治疗24 h后,两组APACHE Ⅱ评分、血氧饱和度、心率、呼吸频率和血气分析无差异性(P>0.05),观察组氧疗累计(17.06±2.82)h长于对照组(12.00±1.41)h(P<0.05),气道管理干预(5.18±1.42)次低于对照组(8.50±2.84)次(P<0.05); 出院时两组APACHE Ⅱ评分、血氧饱和度、心率、呼吸频率、血气参数差异无统计学意义(P>0.05),观察组鼻面部皮肤损伤1例(5.88%)、气道管理干预(30.25±7.99)次、氧疗累计(125.50±19.71)h,对照组鼻面部皮肤损伤7例(35.00%)、气道管理干预(38.17±10.44)次、氧疗累计(92.33±24.73)h(P<0.05); 观察组治疗不佳5例(29.41%),对照组8例(40.00%)(P>0.05); 观察组治疗不耐受例数低于对照组(P<0.05)。 结论 HFNC与NPPV治疗AECOPD伴Ⅱ型呼吸衰竭的疗效无差异性,HFNC耐受性好,优于NPPV。
Abstract:
Objective To compare the curative effect of high-flow nasal cannula oxygen therapy(HFNC)with non-invasive positive pressure ventilation(NPPV)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with type Ⅱ respiratory failure. Methods A total of 37 patients with AECOPD complicated with type Ⅱ respiratory failure in our hospital from January 2020 to June 2023 were selected, and they were randomly divided into observation(17 cases)and control group(20 cases), which were given HFNC or NPPV respectively on the basis of conventional treatments. APACHE Ⅱ, blood gas analysis, heart rate, respiratory rate and SaO2 of patients in the two groups were compared at 24-hour after admission and at discharge respectively. Moreover, number of airway care intervention, accumulated time of oxygen therapy, and treatment failure of two groups were compared during the treatment process. Results APACHE-Ⅱ, blood gas analysis, heart rate, respiratory rate and SaO2 of patients in two groups showed no significant difference between the two groups(P>0.05)at 24-hour after admission and at discharge. The duration of oxygen therapy(17.06±2.82)h in the observation group was longer than that in the control group(12.00±1.41)h, P<0.05, and the duration of airway nursing intervention(5.18±1.42)was lower than that in the control group(8.50±2.84)(P<0.05). At discharge, there were no significant differences in APACHE Ⅱ score, blood oxygen saturation, heart rate, respiratory rate and blood gas parameters between the two groups(P>0.05). In the observation group, there was 1 case of nasal and facial skin injury(5.88%), airway care intervention(30.25±7.99)times, and oxygen therapy accumulated(125.50±19.71)h, while in the control group, there were 7 cases of nasal and facial skin injury(35.00%), airway care intervention(38.17±10.44)times, and oxygen therapy accumulated(92.33±24.73)h, P<0.05; There were 5 cases(29.41%)of poor treatment in observation group and 8 cases(40.00%)in control group, P>0.05. The number of treatment intolerance cases in observation group was lower than that in control group(P<0.05). Conclusion HFNC has similar curative effect with NPPV, but HFNC is better than NPPV due to higher tolerance.

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备注/Memo

备注/Memo:
基金项目: 陕西省重点研发计划项目(2022SF-517)
通信作者: 王永兴, Email: wangyx986zz@163.com
更新日期/Last Update: 2023-12-20