摘要
目的研究经鼻高流量加温湿化吸氧治疗(HFNC)对慢性阻塞性肺病(COPD)合并呼吸衰竭患者的治疗效果。方法选取COPD合并呼吸衰竭患者72例,随机分为治疗组和对照组,每组36例,2组患者均给予常规抗感染、解痉、化痰、抑制气道炎症及纠正电解质紊乱等治疗,治疗组在常规治疗基础上加用经鼻高流量加温湿化吸氧治疗仪,对照组在常规治疗上加用持续低流量鼻导管氧气吸入,观察2组患者治疗前后的临床症状、呼吸频率、心率、pH值、PaCO_2、PaO_2、SaO_2以及不良反应。结果2组患者治疗后呼吸频率、心率、PaCO_2均较治疗前下降(P<0.05),PaO_2、SaO_2均较治疗前上升(P<0.05),对照组pH值在治疗前后无明显改善(P>0.05),治疗组pH值治疗前后有所改善(P<0.05),治疗组治疗后呼吸频率下降程度高于对照组(P<0.05),PaCO_2下降程度高于对照组(P<0.05),2组患者治疗后的心率、pH值、PaO_2、SaO_2无明显差异(P>0.05)。结论经鼻高流量加温湿化吸氧治疗对于COPD合并呼吸衰竭(伴有轻度二氧化碳潴留)患者有良好的治疗效果,能减慢患者呼吸频率、降低PaCO_2、改善患者症状、减少住院天数。
Objective To study the High flow nasal cannula（HFNC）curative effect on patients with Chronic Obstructive Pulmonary Disease（COPD）and respiratory failure.Methods We selected 72patients with COPD and respiratory failure,and divided them into 2groups with 36patients in one group according to random number table and their willingness.Both groups were given conventional treatments such as antiinfection,spasmolysis,phlegm-resolving,airway inflammation inhibition,and electrolyte disturbances correction.In addition,on the basis of routine treatment,observation group was treated with HFNC while the control group was treated with continuous low flow oxygen nasal catheter inhalation.The clinical symptoms,respiratory rate,heart rate,pH,PaCO_2,PaO_2,SaO_2and adverse reactions of two groups before and after the treatment were detected.Results The respiratory rate,heart rate and PaCO_2of the two groups decreased after the treatment（P〈0.05）,and the PaO_2and SaO_2increased compared with the ones before the treatment（P〈0.05）.There was no significant difference in pH value for the control group before and after the treatment（P〈0.05）,whereas the pH in the observation group was improved after the treatment.The decline in respiratory rate of the observation group was more than that of the control group（P〈0.05）and the same result was shown in PaCO_2result（P〈0.05）.There was no obvious difference between the two groups in heart rate,pH,PaO_2and SaO_2after the treatment（P〈0.05）.ConclusionHFNC has a positive curative effect on patients with COPD and respiratory failure（together with mild carbon dioxide retention）.It can slow down the respiratory rate,reduce the PaCO_2,improve the symptoms and reduce hospital day.
作者
远青钊
罗琴
王在义
YUAN Qingzhao;LUO Qin;WANG Zaiyi(Changji People＇s Hospital, Xinjiang Changji, 831100, China;The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China;The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China)
出处
《新疆医科大学学报》
CAS
2018年第5期556-559,564,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区科技支疆项目(201591156)
