摘要
目的:研究经鼻高流量湿化氧疗(HFNC)设备对支气管哮喘急性发作伴I型呼吸衰竭患者的临床辅助治疗效果。方法:选取医院呼吸内科住院的160例支气管哮喘急性发作期患者,根据氧疗方法的不同将其分为HFNC组和常规组,每组80例,HFNC组采用HFNC设备进行氧疗,常规组给予鼻导管供氧治疗。比较治疗后两组临床疗效、预后情况,以及治疗前后血气分析指标和肺功能指标;采用舒适状况量表(GCQ)评估患者舒适度,采用Borg疲劳量表评估患者疲劳程度。结果:治疗后HFNC组和常规组动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))指标均较治疗前明显升高,二氧化碳分压(PaCO_(2))较治疗前明显降低(tHFNC组=27.609,t=55.676,t=34.185;t常规组=16.436,t=21.922,t=11.360;P<0.05);HFNC组对PaO_(2)、PaCO_(2)和SpO_(2)改善明显优于常规组(t=12.778,t=28.209,t=34.742;P<0.01);HFNC组治疗后总有效率为95.00%,明显高于常规组的82.50%(χ^(2)=6.260,P<0.05)。治疗后HFNC组和常规组第1秒用力呼气末容积(FEV1)、用力肺活量比值(FVC)及呼气峰值流速(PEF)指标均较治疗前明显升高,差异具有统计学意义(tHFNC组=16.767,t=25.784,t=16.041;t常规组=7.895,t=5.349,t=8.944;P<0.05);HFNC组FEV1、FVC及PEF水平明显高于常规组(t=4.335,t=10.592,t=8.751;P<0.01)。治疗后HFNC组和常规组患者舒适度评分均较治疗前明显升高、疲劳程度评分较治疗前明显降低,差异具有统计学意义(tHFNC组=104.510,t=19.176;t常规组=49.789,t=5.918;P<0.05),HFNC组对舒适度、疲劳程度评分改善程度明显优于常规组(t=46.006,t=10.989;P<0.01)。治疗后1个月内,HFNC组患者急性发作次数、住院次数明显少于常规组,住院时间明显短于常规组(t=23.425,t=16.613,t=32.218;P<0.01)。结论:HFNC氧疗可有效改善支气管哮喘急性发作伴I型呼吸衰竭患者缺氧症状,改善血气分析指标,提高患者肺功能及舒适程度,减少复发次数及缩短住院时间,促进患者恢复健康,值得临床使用。
Objective: To analyze the clinical effect of high flow nasal cannula(HFNC) humidifying oxygen therapy equipment on patients with bronchial asthma of acute attack stage accompanied by type I respiratory failure. Methods:A total of 160 patients with bronchial asthma of acute attack stage who were hospitalized in department of respiratory medicine of hospital were selected and they were divided into HFNC group and conventional group according to different oxygen therapy methods, with 80 cases in each group. The HFNC group adopted HFNC equipment to conduct oxygen therapy, while the conventional group adopted nasal cannula to conduct oxygen therapy. The clinical effect and prognosis after treatment between two group were compared, and the indicators of arterial blood gas analysis and pulmonary function between before and after treatment were compared, and general comfort questionnaire(GCQ)was adopted to assess the comfort level of patients, and the Borg fatigued scale was adopted to assess the fatigued level of patients. Results: The indexes of arterial partial pressure of oxygen(PaO_(2)) and oxyhemoglobin saturation(SpO_(2)) in both groups after treatment were significantly higher than those before treatment, while partial pressure of carbon dioxide(PaCO_(2)) of two groups after treatment were significantly lower than those before treatment(t=27.609,t=55.676, t=34.185 in HFNC group, t=16.436, t=21.922, t=11.360 in conventional group, P<0.05), respectively.The improvements of PaO_(2), PaCO_(2)and SpO_(2)in HFNC group were significantly better than them in conventional group(t=12.778, t=28.209, t=34.742, P<0.01), respectively. The total effective rate of HFNC group was 95.00%after treatment, which was significantly higher than 82.50% of conventional group, and the difference was statistically significant(x~2=6.260, P<0.05). The indexes of forced end-expiratory volume(FEV1), forced vital capacity(FVC) ratio and peak expiratory flow(PEF) rate at the first second of the two groups after treatment were significantly higher than those before treatment, and the differences of them between two groups were statistically significant(HFNC group t=16.767, t=25.784, t=16.041, Conventional group t=7.895, t=5.349, t=8.944, P<0.05), respectively. The levels of FEV1, FVC and PEF after treatment in HFNC group were significantly higher than those in conventional group, and the difference was statistically significant(t=4.335, t=10.592, t=8.751, P<0.01), respectively. The scores of comfort level of patients in the two groups after treatment were significantly higher than them before treatment, and the fatigue scores of two groups after treatment were significantly lower than them before treatment, the differences of them were statistically significant(t=104.510, t=19.176 in the HFNC group, t=49.789, t=5.918 in the conventional group,P<0.05), respectively, and the improvements of comfort level and fatigue score after treatment in the HFNC group were significantly better than them in the conventional group(t=46.006, t=10.989, P<0.01), respectively. Within one month after treatment, the frequency of acute attacks and hospitalization of patients in HFNC group were significantly less than those in conventional group, and the length of stay of HFNC group was significantly shorter than that of conventional group(t=23.425, t=16.613, t=32.218, P<0.01), respectively. Conclusion: HFNC oxygen therapy can effectively improve the symptoms of hypoxia in patients with bronchial asthma of acute attack companies with type I respiratory failure, and improve the indexes of arterial blood gas analysis, and enhance the pulmonary function and comfort level of patients, and reduce the frequency of recurrence and shorten the length of stay, and promote the rehabilitation of patients. It is worthy to be used in clinical application.
作者
贺向红
池毅
郭立娟
王红景
商焕霞
席素雅
HE Xiang-hong;CHI Yi;GUO Li-juan(The First Section of Respiratory Department,Hebei Chest Hospital,Shijiazhuang 050000,China.)
出处
《中国医学装备》
2023年第2期107-111,共5页
China Medical Equipment
基金
河北省医学科学研究重点课题计划(20180658)“经鼻高流量氧疗对支气管哮喘急性发作患者的疗效分析”。
关键词
经鼻高流量湿化氧疗(HFNC)
支气管哮喘
急性发作
Ⅰ型呼吸衰竭
比较效果研究
High flow nasal cannula(HFNC)humidifying oxygen therapy
Bronchial asthma
Acute attack
TypeⅠrespiratory failure
Comparative effectiveness research
