Ji Wangfei, Zhang Xiaobai, Ji Honghua, Wang Chenhui, Xu Lina
Department of Respiratory Medicine, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, Jiangsu, China.
The Science and Education Department, Nantong Rici Hospital, Nantong Rici Hospital Affiliated to Yangzhou University, Nantong, Jiangsu, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41829. doi: 10.1097/MD.0000000000041829.
This study aims to provide a reference for clinical treatment selection by comparing noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) oxygen therapy in patients with chronic obstructive pulmonary disease (COPD) complicated by community-acquired pneumonia (CAP). From January 2022 to December 2023, 63 patients with COPD and CAP treated at our hospital were enrolled. Patients were allocated to either the NIV group (33 patients) or the HFNC group (30 patients), in addition to receiving conventional treatments. The groups were compared across various parameters including respiratory rate (RR), peripheral oxygen saturation (SpO2), arterial oxygen partial pressure (PaO2), oxygenation index (PaO2/fraction of inspiration O2 [FiO2]), rates of complications, tracheal intubation, mortality, total hospital stay, and hospital costs at 1, 3, and 7 days post-treatment. After 1, 3, and 7 days of treatment, both groups exhibited significant improvements in RR, SpO2, PaO2, and PaO2/FiO2 from baseline (P < .05). The improvements increased over time. However, no significant differences were observed between the NIV and HFNC groups in RR, SpO2, PaO2, and PaO2/FiO2 at the measured time points (P > .05); the HFNC group experienced lower rates of complications such as facial injuries, dry nose and mouth, and bloating (P < .05). No significant differences were found in tracheal intubation rates, mortality rates, total hospital stay, and total hospital costs between the groups (P > .05). Both NIV and HFNC effectively improve respiratory and circulatory parameters in patients with COPD and CAP, with similar efficacy rates. While there were no significant differences in tracheal intubation rates, mortality rates, total hospital duration, and costs, HFNC was associated with fewer complications and greater patient comfort, rendering it a more favorable clinical option.
本研究旨在通过比较无创通气（NIV）和高流量鼻导管（HFNC）氧疗在慢性阻塞性肺疾病（COPD）合并社区获得性肺炎（CAP）患者中的应用，为临床治疗选择提供参考。2022年1月至2023年12月，我院收治的63例COPD合并CAP患者纳入研究。除接受常规治疗外，患者被分为NIV组（33例）和HFNC组（30例）。比较两组患者的呼吸频率（RR）、外周血氧饱和度（SpO2）、动脉血氧分压（PaO2）、氧合指数（PaO2/吸入氧分数[FiO2]）、并发症发生率、气管插管率、死亡率、总住院时间以及治疗后1、3、7天的住院费用。治疗1、3、7天后，两组患者的RR、SpO2、PaO2和PaO2/FiO2较基线均有显著改善（P < 0.05），且改善程度随时间增加。然而，在各测量时间点，NIV组和HFNC组在RR、SpO2、PaO2和PaO2/FiO2方面无显著差异（P > 0.05）；HFNC组面部损伤、口鼻干燥和腹胀等并发症发生率较低（P < 0.05）。两组间气管插管率、死亡率、总住院时间和总住院费用无显著差异（P > 0.05）。NIV和HFNC均能有效改善COPD合并CAP患者的呼吸和循环参数，疗效相似。虽然气管插管率、死亡率、总住院时长和费用无显著差异，但HFNC并发症较少，患者舒适度更高，是更有利的临床选择。
