经鼻高流量湿化氧疗在COPD合并呼吸衰竭病人肺康复中的近期及远期疗效研究

doi:10.3969/j.issn.1003-9198.2022.01.014

摘要/Abstract

摘要： 目的探讨高流量湿化氧疗对COPD合并呼吸衰竭病人血气指标、肺部功能,近期、远期疗效的影响。方法以我院2017年1月至2020年5月老年病科收治的82例COPD合并呼吸衰竭病人作为观察对象,分为观察组42例和对照组40例。观察组病人给予高流量湿化氧疗,对照组给予无创正压通气治疗,比较2组病人干预后3 d的血气指标、肺功能、治疗效果、并发症发生情况及6个月后6分钟步行距离(6MWD)及改良英国医学研究委员会呼吸困难指数(mMRC)、COPD评估测试(CAT)评分、Borg评分与BODE指数结果。结果治疗3 d后,观察组病人PaO₂、FEV1、FEV1占预计值百分比、FVC占预计值百分比、FEV1/FVC均高于对照组(P<0.05),PaCO₂水平低于对照组(P<0.05);观察组的治疗有效率(92.85%)高于对照组(57.50%),2组并发症发生率差异无统计学意义(P>0.05)。随访6个月后,观察组6MWD、mMRC评分高于对照组(P<0.05),CAT评分、Borg评分及BODE指数低于对照组(P<0.05)。结论高流量湿化氧疗可改善COPD合并呼吸衰竭病人的血气指标和肺功能,改善疾病预后,值得临床应用。

关键词: 慢性阻塞性肺疾病, 呼吸衰竭, 经鼻高流量湿化氧疗, 血气指标, 肺功能

Abstract: Objective To explore the effects of high-flow nasal cannula oxygen therapy on blood gas indexes, pulmonary function in chronic obstructive pulmonary disease (COPD) patients complicated with respiratory failure, and to explore the complications and long-term effect. Methods A total of 82 subjects were selected in our hospital from January 2017 to May 2020 and divided into observation group (n=42) and control group (n=40). The patients in observation group received high-flow nasal cannula oxygen therapy, and the patients in control group were treated with non-invasive positive pressure ventilation therapy. The blood gas indexes, pulmonary function, effective rate and the complications after 3 days of treatment and the prognosis after 6 months of treatment were compared between the two groups. Results After 3 days of treatment, the levels of arterial partial pressure of oxygen (PaO₂), forced expiratory volume in 1 s (FEV1), FEV1% predicted(FEV1% pred), forced vital capacity (FVC)% predicted(FVC% pred), FEV1/FVC in observation group were higher than those in control group (P<0.05), while the level of partial pressure of carbon dioxide in artery (PaCO₂) was lower than that in control group(P<0.05). The effective rate of observation group (92.85%) was higher than that of control group (57.50%). There was no significant difference in the incidence rate of complications between the two groups(P>0.05). The 6-minute walk distance (6MWD) and the score of modified British medical research council (mMRC)were higher, while the score of COPD assessment test (CAT), Borg score and BODE index were lower than those in control group after 6 months of follow-up(P<0.05). Conclusions High-flow nasal cannula oxygen therapy can improve the blood gas indicators, pulmonary function and outcome, which has a significant clinical application value.

Key words: chronic obstructive pulmonary disease, respiratory failure, high-flow nasal cannula oxygen therapy, blood gas indicator, pulmonary function

中图分类号:

R 563

王国玉, 石文达, 王璐, 王浩宇. 经鼻高流量湿化氧疗在COPD合并呼吸衰竭病人肺康复中的近期及远期疗效研究[J]. 实用老年医学, 2022, 36(1): 53-56.

WANG Guo-yu, SHI Wen-da, WANG Lu, WANG Hao-yu. Early- and long-term effect of high-flow nasal cannula oxygen therapy on pulmonary rehabilitation in COPD patients complicated with respiratory failure[J]. Practical Geriatrics, 2022, 36(1): 53-56.

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