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高流量鼻导管氧疗对合并 II 型呼吸衰竭的慢性阻塞性肺疾病急性加重患者的影响。

Effects of high-flow nasal cannula oxygen therapy for patients with acute exacerbation of chronic obstructive pulmonary disease in combination with type II respiratory failure.

机构信息

Department of Critical Care Medicine, Affiliated Hai'an Hospital of Nantong University, Hai'an County, Nantong City, Jiangsu Province, 226600, China.

出版信息

J Int Med Res. 2023 Jun;51(6):3000605231182558. doi: 10.1177/03000605231182558.

Abstract

OBJECTIVE

To evaluate the therapeutic effects of high-flow nasal cannula (HFNC) oxygen therapy in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type II respiratory failure.

METHODS

Seventy-two patients with AECOPD and type II respiratory failure were randomly allocated to an HFNC oxygen therapy trial group or a non-invasive positive-pressure ventilator therapy (NIPPV) control group. Their arterial blood gas parameters and comfort, evaluated using a questionnaire, were compared before and after the therapeutic interventions.

RESULTS

The PaCO and blood concentration of both groups were significantly reduced by the treatments, whereas the pH, PaO and PaO/FiO were increased. The PaCO of the experimental group was significantly lower than that of the control group following treatment. The PaO of the experimental group was significantly higher than that of the control group. The tracheal intubation rates of the two groups did not significantly differ. After treatment, all the indices of comfort were rated higher in the HFNC group than in the NIPPV group.

CONCLUSIONS

HFNC has a good therapeutic effect in patients with AECOPD and type II respiratory failure. It improves patient comfort and has clinical value.

摘要

目的

评估高流量鼻导管(HFNC)氧疗在慢性阻塞性肺疾病急性加重(AECOPD)合并 II 型呼吸衰竭患者中的治疗效果。

方法

将 72 例 AECOPD 合并 II 型呼吸衰竭患者随机分为 HFNC 氧疗试验组和无创正压通气(NIPPV)对照组,比较两组治疗前后动脉血气参数和舒适度(采用问卷评估)。

结果

两组患者的 PaCO2 和血 浓度经治疗后均显著降低,而 pH、PaO2 和 PaO2/FiO2 则升高。治疗后,实验组的 PaCO2 明显低于对照组。实验组的 PaO2 明显高于对照组。两组的气管插管率无显著差异。治疗后,HFNC 组在所有舒适度指标上的评分均高于 NIPPV 组。

结论

HFNC 对 AECOPD 合并 II 型呼吸衰竭患者具有良好的治疗效果。它提高了患者的舒适度,具有临床价值。

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