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II型呼吸衰竭的治疗效果分析及对血气变化的影响:高流量鼻导管给氧疗法与无创正压通气的比较

Analysis of therapeutic effects on type II respiratory failure and impact on blood gas changes: high-flow nasal oxygen therapy vs. non-invasive positive pressure ventilation.

作者信息

Liu Yongping, Liu Ning, Li Ying, Nie Lixiu, Li Lin

机构信息

Department of Internal Medicine, Xi'an International Medical Center Hospital No. 777 Xitai Road, Chang'an District, Xi'an 710000, Shaanxi, China.

Department of Cardiovascular Medicine, Urumqi Friendship Hospital No. 558 Shengli Road, Tianshan District, Urumqi 830049, The Xinjiang Uygur Autonomous Region, China.

出版信息

Am J Transl Res. 2024 Feb 15;16(2):487-495. doi: 10.62347/MUHL4407. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the efficacy of high-flow nasal oxygen therapy (HFNO) vs. non-invasive positive pressure ventilation (NIPPV) in type II respiratory failure, and analyze their impact on blood gas parameters.

METHODS

A retrospective analysis of 110 cases of type II respiratory failure treated from April 2021 to March 2023 categorized patients into control (NIPPV, n=50) and observation (HFNO, n=60) groups. Both groups received comprehensive nursing interventions. Treatment outcomes, respiratory and hemodynamic parameters, blood gas parameters, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were compared before and 48 hours after treatment. Additionally, the complication rates and independent risk factors affecting prognosis were analyzed.

RESULTS

The observation group exhibited superior treatment efficacy compared to the control group (P=0.001). Both groups showed significant improvements in APACHE II scores and respiratory, hemodynamic, and blood gas parameters after treatment (P<0.001), with the observation group experiencing more pronounced improvements (P<0.001). The observation group also had a lower incidence of complications than the control group (P=0.013). Logistic regression identified PaCO and treatment protocol as independent risk factors affecting adverse outcomes (P<0.05).

CONCLUSION

HFNO demonstrates superior therapeutic efficacy in type II respiratory failure, significantly improving blood gas parameters with a high level of safety, supporting its clinical applicability.

摘要

目的

评估高流量鼻导管吸氧疗法(HFNO)与无创正压通气(NIPPV)治疗Ⅱ型呼吸衰竭的疗效,并分析它们对血气参数的影响。

方法

对2021年4月至2023年3月治疗的110例Ⅱ型呼吸衰竭患者进行回顾性分析,将患者分为对照组(NIPPV,n = 50)和观察组(HFNO,n = 60)。两组均接受综合护理干预。比较治疗前及治疗48小时后两组的治疗效果、呼吸和血流动力学参数、血气参数以及急性生理与慢性健康状况评分系统Ⅱ(APACHE II)评分。此外,分析并发症发生率及影响预后的独立危险因素。

结果

观察组治疗效果优于对照组(P = 0.001)。两组治疗后APACHE II评分及呼吸、血流动力学和血气参数均有显著改善(P < 0.001),观察组改善更明显(P < 0.001)。观察组并发症发生率也低于对照组(P = 0.013)。Logistic回归分析确定PaCO和治疗方案是影响不良结局的独立危险因素(P < 0.05)。

结论

HFNO治疗Ⅱ型呼吸衰竭疗效显著,能显著改善血气参数,安全性高,具有临床应用价值。

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