摘要
背景间质性肺炎在无明显诱因的情况下疾病发生恶化会影响患者有创机械通气治疗效果,且患者发生呼吸衰竭的风险较高,因此及时寻找更为有效的治疗方法对改善间质性肺炎急性加重(AE-IP)患者的预后具有重要意义。目的观察高流量鼻导管氧疗(HFNC)治疗AE-IP患者的疗效,以期为临床优化AE-IP患者的呼吸管理策略提供参考。方法选取2012年8月—2018年7月首都医科大学附属北京友谊医院平谷医院收治的AE-IP患者96例,按照随机分组原则分为对照组(n=53)和观察组(n=43)。对照组患者采用无创通气(NIV)治疗,观察组患者采用HFNC治疗;两组患者均治疗1周。比较两组患者基线资料、院内病死率、住院时间、ICU/过渡监护治疗病房(IMCU)入住时间、呼吸支持期间镇静剂和镇痛剂使用情况、停止口服药物情况及不良事件(包括气胸、谵妄)发生率。绘制Kaplan-Meier生存曲线以评估患者90 d累积生存率。结果观察组患者院内病死率、使用镇静剂者所占比例、使用镇痛剂者所占比例、停止口服药>24 h者所占比例低于对照组(P<0.05)。观察组患者90 d累积生存率高于对照组(P<0.05)。两组患者住院时间、ICU/IMCU入住时间、不良事件发生率比较,差异无统计学意义(P>0.05)。结论HFNC可有效降低AE-IP患者的院内病死率、镇静与镇痛剂使用率,且安全性较高,可作为AE-IP患者呼吸管理的一种可行性选择。
Background Interstitial pneumonia without significant inducement,the deterioration of disease has poor effect on patients with invasive mechanical ventilation,and the proportion of respiratory failure is high.Therefore,it is of great significance for the prognosis of patients with acute exacerbation of interstitial pneumonia(AE-IP)to timely search for more effective treatment.Objective To investigate the effect of high flow nasal cannula oxygen therapy(HFNC)in the treatment of patients with AE-IP,in order to provide reference for clinical optimization of respiratory management strategy for patients with AE-IP.Methods 96 patients with AE-IP who were treated in Beijing Friendship Hospital Pinggu Campus,Capital Medical University from August 2012 to July 2018 were selected.They were divided into control group(n=53)and observation group(n=43)according to the principle of randomization.Patients in the control group were treated with noninvasive ventilation(NIV),and patients in the observation group were treated with HFNC;both groups were treated for 1 week.The baseline data,hospital mortality,hospital stay,ICU/IMCU stay,use of sedatives and analgesics during respiratory support,cessation of oral medications,incidence of adverse events(including pneumothorax and delirium)were compared between the two groups.Kaplan-Meier survival curve was drawn to assess the cumulative survival rate of patients at 90 days.Results The hospital mortality,proportion of use of sedatives and analgesics,and the proportion of cessation of oral medications for more than 24 hours in observation group were statistically significantly lower than those in control group(P<0.05).The cumulative survival rate at 90 days in observation group was statistically significantly higher than that in control group(P<0.05).There was no statistically significant difference in hospital stay,ICU/IMCU stay and incidence of adverse events between the two groups(P>0.05).Conclusion HFNC can effectively reduces the hospital mortality,proportion of use of sedatives and analgesics in patients with AE-IP,and has high safety,which can be used as a feasible option for respiratory management of patients with AE-IP.
作者
杨晓辉
张凤革
郑文旭
符学浩
YANG Xiaohui;ZHANG Fengge;ZHENG Wenxu;FU Xuehao(Department of General Medical,Beijing Friendship Hospital Pinggu Campus,Capital Medical University,Beijing 101212,China)
出处
《实用心脑肺血管病杂志》
2020年第8期74-78,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
间质性肺炎
高流量鼻导管氧疗
无创通气
治疗结果
Interstitial pneumonia
High flow nasal cannula oxygen therapy
Noninvasive ventilation
Treatment outcome
