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Clinical efficacy of transnasal high flow oxygen inhalation therapy in patients with acute exacerbation of chronic obstructive pulmonary disease |
WANG Lanlan LU Yang QIU Xia#br# |
Department of ICU, Zhoushan Women and Children Hospital, Zhejiang Province, Zhoushan 316000, China
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Abstract Objective To investigate the clinical effect of transnasal high flow oxygen inhalation therapy in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Sixty-six patients with AECOPD treated in Zhoushan Women and Children Hospital from February 2019 to August 2020 were selected and they were divided into control group and observation group according to random number table method, with 33 cases in each group. The control group was treated with noninvasive positive pressure ventilation therapy, and the observation group was treated with transnasal high flow oxygen inhalation therapy. The indexes of blood gas analysis, respiratory rate, heart rate, incidence of complications, reintubation and length of stay in ICU were compared between two groups. Results After treatment, the arterial partial pressure of oxygen and saturation of blood oxygen in two groups were higher than those before treatment, and observation group was higher than control group, the differences were statistically significant (P < 0.05). The arterial partial pressure of carbon dioxide in two groups was lower than that before treatment, and observation group was lower than control group, the differences were statistically significant (P < 0.05). After treatment, respiratory rate and heart rate of two groups were lower than those before treatment, and observation group was lower than control group, the differences were statistically significant (P < 0.05). The incidence rates of bronchospasm, facial and nasal injury, and gastrointestinal flatulence in observation group were lower than those in control group, and the length of stay in ICU of observation group was shorter than that of control group, the differences were statistically significant (P < 0.05). There was no significant difference on reintubation rate between two groups (P > 0.05). Conclusion Transnasal high flow oxygen inhalation in the treatment of AECOPD patients can significantly improve the effect of blood gas indexes and symptoms, and reduce complications.
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[参考文献]
[1] 曹爱琴,许林.肺康复在慢性阻塞性肺疾病中的应用进展[J].中国医药科学,2021,11(19):71-74.
[2] 苏建,倪吉祥,王迎难.经鼻高流量吸氧和经口鼻面罩无创正压通气呼吸机在轻中度COPD合并轻中度低氧血症中运用的对比[J].国际呼吸杂志,2020,40(22):1741-1745.
[3] 郭晓斌,冯可青,赵丽敏,等.慢性阻塞性肺疾病急性加重期患者肺部真菌感染的相关因素分析[J].中华医院感染学杂志,2018,28(9):1313-1315.
[4] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性阻塞性肺疾病基层诊疗指南(2018年)[J].中华全科医师杂志,2018,17(11):856-870.
[5] 吴琼,郭秀君,李状双,等.慢性阻塞性肺疾病急性加重期中医临床护理路径的构建[J].护理研究,2019,33(18):3107-3112.
[6] 陈节,杨蔚,孙红梅.经鼻高流量加温湿化吸氧辅助治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭效果及安全性分析[J].临床误诊误治,2019,32(8):50-54.
[7] 颜沃志,麦伟忠,谭英强.慢性阻塞性肺疾病急性加重期患者肺功能与血气分析、炎症指标的关系分析[J].中国医药科学,2019,9(24):268-270.
[8] 柴书坤,王震,王小琳,等.经鼻高流量吸氧对AECOPD合并Ⅱ型呼吸衰竭患者疗效及近期预后的影响[J].河北医科大学学报,2020,41(7):764-767.
[9] 刘慧梅,徐世林.经鼻高流量加温湿化吸氧与无创机械通气在慢性阻塞性肺疾病患者中的应用[J].海军医学杂志,2020,41(1):103-105.
[10] 何梅,于素娥,洪光朝,等.慢性阻塞性肺疾病急性加重期进行呼吸康复对健康相关生存质量变化的影响[J].中国康复医学杂志,2018,33(6):636-641.
[11] 王林梅,齐景宪,冯青青.慢性阻塞性肺疾病急性加重期和稳定期患者血清IL-8、TNF-α及免疫因子的检测[J].郑州大学学报(医学版),2018,53(2):255-258.
[12] 林茜,贾鹏,李晓琴,等.高流量鼻导管吸氧对比经鼻持续气道正压通气治疗新生儿呼吸窘迫综合征疗效的Meta分析[J].中国当代儿科杂志,2020,22(11):1164-1171.
[13] 彭俊,陈羽青,叶健鸿,等.经鼻高流量吸氧对预充氧及安全窒息时限的影响[J].中山大学学报(医学版),2018, 39(2):263-268.
[14] 李丽莉,代冰,董新新.患者拔除气管插管后应用经鼻高流量氧疗效果的Meta分析[J].中华护理杂志,2018, 53(12):1492-1497.
[15] 余优琴,诸葛建成,王春林,等.经鼻高流量氧疗与无创正压通气交替治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的临床研究[J].中华危重症医学杂志(电子版),2019,12(2):104-108.
[16] 张梅,王美堂.经鼻导管高流量吸氧在慢性阻塞性肺疾病加重期的应用进展[J].临床急诊杂志,2020,21(7):599-602.
[17] 柴书坤,王小琳,史金英,等.经鼻高流量吸氧治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床研究[J].河北医药,2019,41(20):3110-3113.
[18] 解立新.经鼻高流量湿化氧疗治疗慢性阻塞性肺疾病急性加重——临床与研究的证据[J].广东医学,2020,41(7):666-667.
[19] 杨圣强,张贵真,刘贞,等.经鼻高流量氧疗对慢性阻塞性肺疾病急性加重患者膈肌功能的影响:一项前瞻性随机对照研究[J].中华危重病急救医学,2019,31(5):551-555.
[20] 胡述立,汤浩,范学朋.经鼻高流量氧疗与无创正压通气在不同APACHE Ⅱ评分老年AECOPD患者中拔管后的治疗效果研究[J].中国全科医学,2018,21(15):1790-1795.
[21] 张艳喜,尚龙梅,芮晓艳.经鼻高流量湿化氧疗及鼻导管氧疗治疗慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者的效果[J].中国医药导报,2022,19(7):112-115.
[22] 陈龙,张丹嗣,刘丹舟.经鼻高流量湿化氧疗对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者血气分析指标及平均动脉压的影响[J].临床和实验医学杂志,2020,19(21):2295-2299.
[23] 于斐,冯波,姚媛媛.急性低氧性Ⅰ型呼吸衰竭患者经鼻高流量氧疗的气道管理[J].护理学杂志,2018,33(8):11-13.
[24] 冯晓东,张贵良,曾利华,等.经鼻高流量氧疗治疗急性呼吸衰竭的随机对照试验[J].中国呼吸与危重监护杂志,2020,19(5):489-494.
[25] 李丽荣,付会恒,田亚莉.经鼻高流量鼻导管湿化氧疗治疗中老年重症难治性肺炎合并呼吸衰竭的临床观察[J].中国医药科学,2020,10(22):200-203.
[26] 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.
[27] 苏航.经鼻高流量氧疗与无创正压通气交替治疗慢性阻塞性肺疾病急性发作合并呼吸衰竭的效果比较[J].中国当代医药,2020,27(17):54-57.
[28] 远青钊,罗琴,王在义.经鼻高流量加温湿化吸氧治疗在慢性阻塞性肺病合并呼吸衰竭患者中应用的疗效观察[J].新疆医科大学学报,2018,41(5):556-559.
[29] 谈定玉,吕菁君,罗杰英,等.急诊成人经鼻高流量氧疗临床应用专家共识[J].中国急救医学,2021,41(9):739-749.
[30] 李琦,刘双林,刘刚.经鼻高流量氧疗与无创正压通气的合理应用[J].中华结核和呼吸杂志,2020,43(9):733-736. |
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