摘要
目的观察应用经鼻高流量湿化氧疗对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者血气分析指标及平均动脉压的影响,以期为临床治疗提供理论参考。方法回顾性收集2019年1月至2020年1月辽健集团阜新矿总医院收治的96例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的相关资料,按治疗方法不同分为研究组(48例,给予经鼻高流量湿化氧疗治疗)和对照组(48例,给予经鼻导管低流量氧气吸入治疗)。统计治疗前、治疗开始(2 h、12 h、24 h、36 h、72 h)后的血气分析指标[动脉血氧分压(Pa O2)、二氧化碳分压(Pa CO2)、Pa O2/吸入气氧含量(Fi O2)及p H值]、平均动脉压、心率及呼吸频率的变化情况;统计中性粒细胞/淋巴细胞(NLR)及血浆内皮素(EF)-1;记录不良反应发生率。结果①治疗2~72 h后,2组Pa O2和Pa O2/Fi O2均随治疗时间延长而显著增加,而Pa CO2则随治疗时间延长而显著降低(P<0.05),而2组各个时间线p H水平比较差异无统计学意义(P>0.05)。与对照组治疗后相比,治疗2~72 h后研究组Pa O2均显著升高(P<0.05),治疗36~72 h后研究组Pa CO2显著降低(P<0.05),治疗12 h时研究组Pa O2/Fi O2显著增加(P<0.05);治疗2~72 h后,2组平均动脉压、心率及呼吸频率均随治疗时间延长而显著降低,且治疗后均较治疗前降低(P<0.05);治疗2~72 h后,与对照组相比,研究组以上指标也均显著降低,差异具有统计学意义(P<0.05)。②研究组NLR及(EF)-1水平均低于对照组(P<0.05)。③研究组的不良反应发生率明显低于对照组(P<0.05),而2组再次插管率及病死率相比差异无统计学意义(P>0.05)。结论采用经鼻高流量湿化氧疗可有效改善慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者血气分析指标,降低平均动脉压、心率及呼吸频率,且可降低NLR及EF-1水平,不良反应少,值得临床推广使用。
Objective To observe the effect of nasal high-flow humidified oxygen therapy on blood gas analysis indexes and mean arterial pressure in patients with chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure,in order to provide theoretical reference for clinical treatment.Methods Relevant data of 96 patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure admitted to Fuxin Mine General Hospital of Liaojian Group from January 2019 to January 2020 were collected retrospectively and they were divided into research groups(48 cases,given transnasal Flow humidification oxygen therapy)and control group(48 cases,given low-flow oxygen inhalation therapy through nasal catheter).Statistics of blood gas analysis indexes,average arterial pressure,heart rate and respiratory rate before and after treatment(2,12,24,36,72)h,statistics of neutrophils/lymphocytes(NLR)and plasma Endothelin(EF)-1,record the incidence of adverse events.Results①After 2 h to 72 h of treatment,Pa O2 and Pa O2/Fi O2 in both groups increased significantly with the extension of treatment time,while Pa CO2 decreased significantly with the extension of treatment time(P<0.05),while there was no statistically significant difference between the two groups in each timeline pH level(P>0.05).Compared with the control group after treatment,Pa O2 in the study group increased significantly after 2 to 72 hours of treatment(P<0.05),Pa CO2 in the study group decreased significantly after 36 h to 72 h of treatment(P<0.05),Pa O2/Fi O2 in the study group increased significantly at 12 hours of treatment(P<0.05);After 2 hours to 72 hours of treatment,the average arterial pressure,heart rate and respiratory rate of the two groups were significantly reduced with the extension of the treatment time,and after treatment were lower than before treatment(P<0.05);After 2 h to 72 h of treatment,compared with the control group,the above indicators in the study group were also significantly reduced(P<0.05).②The level of NLR and EF-1 in the study group was lower than that in the control group(P<0.05).③The incidence of adverse reactions in the study group was significantly lower than that in the control group(P<0.05),and there was no statistically significant difference in reintubation rate and mortality between the two groups(P>0.05).Conclusion The use of nasal high-flow humidified oxygen therapy can effectively improve the blood gas analysis indexes of patients with chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure,reduce the average arterial pressure,heart rate and respiratory rate,and can reduce the level of NLR and EF-1.The reaction is small,and it is worthy of clinical promotion.
作者
陈龙
张丹嗣
刘丹舟
CHEN Long;ZHANG Dan-si;LIU Dan-zhou(Department of Intensive Medicine,Fuxin General Hospital of Liaoning Health Industry Group,Fuxin Liaoning 123000,China)
出处
《临床和实验医学杂志》
2020年第21期2295-2299,共5页
Journal of Clinical and Experimental Medicine
基金
辽宁省医学科技奖项目(编号:2016-1-55)。
关键词
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
经鼻高流量湿化氧疗
血气分析
平均动脉压
Chronic obstructive pulmonary disease
TypeⅡrespiratory failure
Nasal high-flow humidified oxygen therapy
Blood gas analysis
Mean arterial pressure
