|
|
Effect of transnasal high-flow nasal cannula oxygen therapy and nasal catheter oxygen therapy on patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure#br# |
ZHANG Yanxi SHANG Longmei RUI Xiaoyan▲ |
Department of Respiratory, the First People’s Hospital of Chuzhou, Anhui Province, Chuzhou 239000, China |
|
|
Abstract Objective To explore the therapeutic effect of transnasal high-flow nasal cannula oxygen therapy (HFNC) and nasal catheter oxygen therapy (NCO) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type Ⅱ respiratory failure. Methods A total of 80 patients with AECOPD complicated with type Ⅱ respiratory failure admitted to Department of Respiratory, the First People’s Hospital of Chuzhou of Anhui Province from March 2018 to March 2021 were selected as the research objects. The patients were divided into observation group and control group by random number table method, with 40 cases in each group. HFNC was added to the basic treatment in the observation group, and NCO was added to basic treatment in the control group. The total treatment time of two groups was more than or equal to three days. The heart rate, respiratory rate and mean arterial pressure of the two groups before and after treatment were compared. Arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2), and partial pressure of oxygen in arterial blood / fractional concentration of inspiratory oxygen (PaO2/FiO2) of the two groups before and after treatment were compared. The comfort level of treatment was investigated at discharge. Results After three days of treatment, heart rate, respiratory rate and mean arterial pressure in two groups were significantly decreased compared with before treatment, and observation group was lower than control group, the differences were statistically significant (P < 0.05). After three days of treatment, the levels of PaO2 and PaO2/FiO2 in two groups were significantly increased compared with before treatment, and PaCO2 was significantly decreased compared with before treatment, the differences were statistically significant (P < 0.05). There were no significant differences in PaO2, PaCO2, and PaO2/FiO2 levels between two groups before and after three days of treatment (P > 0.05). Comparison of treatment comfort between the two groups showed highly statistically significant difference (P < 0.01). Conclusion HFNC and NCO both have relatively stable efficacy for patients with AECOPD combined with type Ⅱ respiratory failure, but HFNC has a better remission rate and treatment comfort compared with NCO. HFNC can be widely used for patients requiring oxygen therapy in clinical practice.
|
|
|
|
|
[1] 杨珍娇,崔妙玲,张小芳,等.慢性阻塞性肺疾病急性加重期患者症状群及其影响因素研究[J].护理学杂志,2020, 35(3):30-34.
[2] 王明航,李晓俊,陈学昂,等.慢性阻塞性肺疾病急性加重风险预警体系专家调查[J].中医杂志,2018,59(20):1735-1741.
[3] 李建生,张海龙,王海峰,等.慢性阻塞性肺疾病证候演变特点临床调查[J].中医杂志,2017,58(9):772-776.
[4] 郝文东,王国芳,张彩莲.双水平气道正压通气联合布地奈德福莫特罗对慢性阻塞性肺疾病急性加重合并Ⅱ型呼吸衰竭患者肺康复作用[J].中国老年学杂志,2019,39(3):560-562.
[5] 胡斯明,徐晓,叶辛幸.BiPAP无创辅助通气治疗老年慢性阻塞性肺疾病患者急性加重期合并急性左心衰的临床疗效[J].中国老年学杂志,2016,36(2):379-381.
[6] 汤兵,陈敏,练祥忠,等.阻塞性肺疾病急性加重期痰热壅肺证与临床指标的相关性研究[J].中国循证医学杂志,2016,16(8):876-881.
[7] 肖甜,陈晓英,王娜,等.中国城市社区COPD患者急性加重的相关因素调查[J].中华疾病控制杂志,2017,21(2):110-113,122.
[8] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组,中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会.慢性阻塞性肺疾病诊治指南(2021年修订版)[J].中华结核和呼吸杂志,2021,44(3):170-205.
[9] Marchioni A,Tonelli R,Fantini R,et al. Respiratory Mechanics and Diaphragmatic Dysfunction in COPD Patients Who Failed Non-Invasive Mechanical Ventilation [J]. Int J Chron Obstruct Pulmon Dis,2019,22(14):2575-2585.
[10] 卫尹,倪英,刘亮亮,等.基于JBI临床证据实践应用系统的老年COPD患者氧疗管理实践[J].护理学杂志,2017, 32(13):1-5.
[11] Leung JM,Tiew PY,Mac Aogáin M,et al. The role of acute and chronic respiratory colonization and infections in the pathogenesis of COPD [J]. Respirology,2017,22(4):634-650.
[12] 李娇,王宋平.慢性阻塞性肺疾病急性加重期患者预后的影响因素[J].中国老年学杂志,2019,39(12):2907-2910.
[13] 郑丽君,贾婉茹,陈琼.老年COPD稳定期患者家庭氧疗分级管理的效果评价[J].中华护理杂志,2017,52(10):1241-1246.
[14] 赵春柳,黄靓雯,张利,等.慢性阻塞性肺疾病急性加重住院患者呼吸道病毒感染与炎症细胞因子的相关性[J].中华结核和呼吸杂志,2018,41(12):942-948.
[15] 胡嫣,韩芳.经鼻高流量湿化氧疗在睡眠呼吸疾病中的临床应用[J].中华结核和呼吸杂志,2018,41(2):130-132.
[16] 陈学昂,李素云,王明航,等.慢性阻塞性肺疾病急性加重期预后影响因素的研究进展[J].中华中医药学刊,2017,35(4):799-802.
[17] Kichloo A,Aljadah M,Vipparla N,et al. Optimal glucocorticoid dose and the effects on mortality,length of stay,and readmission rates in patients diagnosed with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)[J]. J Investig Med,2019,67(8):1161-1164.
[18] 耿希华.经鼻高流量湿化氧疗系统在心胸外科术后急性呼吸衰竭患者中的应用[J].山东医药,2016,56(45):94-96.
[19] Rogliani P,Calzetta L,Matera MG,et al. Inhaled therapies and cardiovascular risk in patients with chronic obstructive pulmonary disease [J]. Expert Opin Pharmacother,2019,20(6):737-750.
[20] 吴月姣,杨淑梅,陈瑞琳.高流量湿化氧疗的临床应用研究进展[J].中国全科医学,2019,22(18):2253-2257.
[21] 刘春艳,乔志飞,李福龙,等.经鼻高流量湿化氧疗对老年AECOPD合并Ⅱ型呼吸衰竭患者肺动脉压、ET-1及NLR的影响[J].中国老年学杂志,2019,39(22):5501-5505.
[22] 王建军,姜宏英,李勍.经鼻高流量湿化氧疗与无创正压通气治疗慢性阻塞性肺疾病急性加重伴Ⅱ型呼吸衰竭的随机对照研究[J].中国急救医学,2019,39(10):945-948.
[23] 陈照家,吴建华,王耀勇.经鼻高流量湿化氧疗在Ⅱ型呼吸衰竭中的应用进展[J].疑难病杂志,2021,20(3):310-314,319.
[24] 廖军红,黄兰卿,梁红卫.经鼻高流量氧疗(HFNC)在重症肺炎并呼吸衰竭患者中的应用研究[J].中国医药科学,2021,11(21):220-224.
[25] 韩进海,王皓,孙晓林,等.经鼻高流量氧疗在高原地区慢性阻塞性肺疾病急性加重合并呼吸衰竭患者中的应用[J].中华危重症医学杂志:电子版,2019,12(5):323-327.
[26] 王士伟,徐瑞.高流量氧疗与无创正压通气对AECOPD患者肺功能的影响[J].中国急救复苏与灾害医学杂志,2020,15(11):1275-1278.
[27] 刘如安,赵凯.经鼻高流量湿化氧疗与无创正压通气治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭的疗效比较[J].中国医药,2020,15(12):1853-1856.
[28] 谈定玉,徐艳,王云云,等.经鼻高流量氧疗在慢性阻塞性肺疾病急性加重无创正压通气间歇期应用的探索性研究[J].中华急诊医学杂志,2020,29(8):1046-1052.
[29] 张族勤.慢性阻塞性肺疾病患者有创通气拔管后序贯经鼻高流量氧疗-无创正压通气交替治疗的效果观察[J].中国当代医药,2021,28(16):21-24,35.
[30] Pisani L,Astuto M,Prediletto I,et al. High flow through nasal cannula in exacerbated COPD patients:a systematic review [J]. Pulmonology,2019,25(6):348-354. |
|
|
|