实用老年医学

实用老年医学 ›› 2021, Vol. 35 ›› Issue (10): 1023-1026.doi: 10.3969/j.issn.1003-9198.2021.10.007

• 临床研究 • 上一篇    下一篇

新型高流量湿化氧疗对老年卒中相关性肺炎病人的治疗效果

胡樱, 陆敏, 詹慧   

  1. 210006 江苏省南京市,南京医科大学附属南京医院(南京市第一医院)神经内科
  • 收稿日期:2020-12-05 出版日期:2021-10-20 发布日期:2021-10-13
  • 通讯作者: 詹慧,Email:752177545@qq.com
  • 基金资助:
    国家自然科学基金青年科学基金资助项目(81901215)

Effect of new high-flow humidified oxygen therapy in elderly patients with stroke-associated pneumonia

HU Ying, LU Min, ZHAN Hui   

  1. Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
  • Received:2020-12-05 Online:2021-10-20 Published:2021-10-13

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摘要： 目的 探讨新型高流量湿化氧疗对老年卒中相关性肺炎(SAP)病人的治疗效果。 方法 选取2017年9月至2019年9月我院神经内科ICU收治的70例老年急性缺血性脑卒中(AIS)血管内介入治疗术后并发SAP病人,按照随机数字表将其分为研究组和对照组,每组各35例。2组均给予抗炎、祛痰、止咳等基础疗法,研究组使用经鼻高流量呼吸湿化氧疗,对照组采用传统鼻导管或面罩氧疗方式进行治疗。比较2组治疗前后的临床肺部感染评分(CPIS)及动脉血气分析指标、WBC、hs-CRP水平。统计并比较2组病人的住院时间。 结果 2组治疗前及治疗后24 h CPIS评分差异均无统计学意义(P>0.05);2组治疗后36 h、7 d,CPIS评分均较治疗前明显下降,且研究组下降更显著,差异均有统计学意义(P<0.05)。2组治疗后pH值、PaO2、PaCO2、WBC、hs-CRP水平均较治疗前显著改善(P<0.05),且研究组pH值显著高于对照组(P<0.05);但2组PaO2、PaCO2、WBC、hs-CRP水平差异均无统计学意义(P>0.05)。研究组的平均住院时间显著短于对照组(P<0.001)。 结论 新型高流量湿化氧疗能显著改善老年SAP病人的血气水平及肺部感染情况,缩短住院时间。

关键词: 卒中相关性肺炎, 高流量, 湿化氧疗, 老年人, 急性缺血性脑卒中, 血管内介入治疗

Abstract: Objective To investigate the effect of new high-flow humidified oxygen therapy in the elderly patients with stroke-associated pneumonia (SAP). Methods A total of 70 elderly patients with acute ischemic stroke (AIS) complicated with SAP after intravascular interventional treatment in the Intensive Care Unit of Neurology Department of our hospital from September 2017 to September 2019 were enrolled, and they were divided into the intervention group and the control group by random number table, with 35 cases in each group. Both groups were given standard treatment such as anti-inflammation, expectorant and antitussive drugs. The intervention group was treated with nasal high-flow humidified oxygen therapy, while the control group was treated with conventional oxygen therapy by nasal cannula or face mask. The clinical pulmonary infection score (CPIS) and the levels of arterial blood gas analysis indexes, white blood cell (WBC) and high-sensitivity C-reaction protein (hs-CRP) in the two groups were compared before and after treatment. The hospitalization time of the two groups was recorded and compared. Results There was no significant difference in CPIS between the two groups before treatment and 24 h after treatment (P>0.05). The level of CPIS of the intervention group was significantly lower than that of the control group 36 h and 7 d after treatment. After treatment, the levels of pH value and arterial partial pressure of oxygen (PaO2) were significantly higher, and the levels of arterial partial pressure of carbon dioxide (PaCO2), WBC and hs-CRP were significantly lower in both groups than those before treatment. The pH value of the intervention group was higher than that of the control group (P<0.05). There were no significant differences in the levels of PaO2, PaCO2, WBC and hs-CRP between the two groups after treatment (P>0.05). The average hospital stay in the intervention group was shorter than that in the control group (P<0.001). Conclusions The new high-flow humidified oxygen therapy can significantly improve the blood gas level and pulmonary infection in the elderly SAP patients, and shorten the hospitalization duration.

Key words: stroke-related pneumonia, high-flow, humidified oxygen therapy, aged, acute ischemic stroke, intravascular interventional treatment

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