摘要
目的 探讨无创通气(NIV)与经鼻高流量氧疗(HFNC)在老年重症肺炎(SP)合并呼吸衰竭治疗中的应用效果。方法 采用随机数字表法,将成都市第三人民医院2017年8月—2021年4月收治的96例老年重症肺炎合并呼吸衰竭患者分为观察组(n=48)及对照组(n=48),对照组采用NIV治疗,观察组采用HFNC治疗。比较2组治疗前后肺功能、血气指标、 hs-CRP、 PARC/CCL18和并发症。结果 观察组治疗总有效率为87.50%优于对照组70.83%(P<0.05);观察组治疗后的SaO_(2)、 PaO_(2)、 FEV1、 MVV和FVC均高于对照组,PaCO_(2)、 hs-CRP和PARC/CCL18均低于对照组(P<0.001);观察组并发症发生率为8.33%低于对照组25.00%(P<0.05)。结论 HFNC治疗老年SP合并呼吸衰竭的疗效优于NIV,HFNC能促进肺功能恢复,调节血气指标,改善血清hs-CRP和PARC/CCL18水平,减少并发症。
Objective To explore the effects of non-invasive ventilation(NIV) and high-flow nasal cannula oxygen therapy(HFNC) in the treatment of severe pneumonia(SP) complicated with respiratory failure in the elderly.Methods A total of 96 elderly patients with SP complicated with respiratory failure admitted to Third People’s Hospital of Chengdu City from August 2017 to April 2021 were divided into observation group(n=48) and control group(n=48) by random number table method.The control group was treated with NIV,and the observation group was treated with HFNC.The lung function,blood gas indexes,hs-CRP and PARC/CCL18 before and after treatment,and complications were compared between the two groups.Results The total effective rate of the observation group(87.50%) was higher than that of the control group(70.83%)(P<0.05).After treatment,SaO_(2),PaO_(2),FEV1,MVV and FVC in the observation group were higher than those in the control group,and PaCO_(2),hs-CRP and PARC/CCL18 were lower than those in the control group(P<0.001).The incidence of complications in the observation group was significantly lower than that in the control group(8.33% vs 25.00%)(P<0.05).Conclusion HFNC is superior to NIV in the treatment of elderly SP patients with respiratory failure.HFNC can promote lung function recovery,regulate blood gas indexes,improve serum levels of hs-CRP and PARC/CCL18,and reduce complication.
作者
余红
张川
乐涛
王玺
张玉洁
钟金兰
Yu Hong;Zhang Chuan;Le Tao;Wang Xi;Zhang Yujie;Zhong Jinlan(Department of Critical Care Medicine,Third People's Hospital of Chengdu City,Chengdu,Sichuan,610000,P.R.China)
出处
《老年医学与保健》
CAS
2022年第5期1075-1078,1092,共5页
Geriatrics & Health Care
基金
四川省医学会重症医学(宜昌人福)科研项目(2016ZZ002)。
关键词
老年
重症肺炎
呼吸衰竭
无创通气
经鼻高流量氧疗
elderly
severe pneumonia
respiratory failure
non-invasive ventilation
high-flow nasal cannula oxygen therapy
