摘要
目的探讨经鼻高流量氧疗联合无创正压通气治疗老年慢性阻塞性肺疾病(慢阻肺)合并呼吸衰竭的临床疗效。方法选取2016年1月至2019年12月本院收治的72例慢阻肺合并呼吸衰竭老年患者作为研究对象,根据红蓝数字抽签法分为对照组与分析组,各36例。对照组给予无创正压通气治疗,分析组给予经鼻高流量氧疗与无创正压通气治疗,比较两组临床疗效、不良反应发生率、呼吸力学指标及治疗前后肺功能指标。结果分析组治疗总有效率为94.44%,高于对照组的77.78%,差异有统计学意义(P<0.05)。分析组不良反应发生率为8.33%,低于对照组的27.78%,差异有统计学意义(P<0.05)。治疗后,分析组潮气量(VT)、每分钟通气量(MV)均大于对照组,浅快呼吸指数(RSBI)低于对照组,吸气时间(Ti)短于对照组,差异有统计学意义(P<0.05)。治疗后,两组用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)均高于治疗前,且分析组明显高于对照组,差异均有统计学意义(P<0.05)。结论经鼻高流量氧疗联合无创正压通气治疗老年慢阻肺合并呼吸衰竭效果显著,不仅能快速调节其呼吸力学指标与肺功能指标水平,且不良反应发生率较低,治疗安全性高,值得临床推广应用。
Objective To investigate the clinical effect of nasal high-flow oxygen therapy combined with non-invasive positive pressure ventilation in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure.Methods 72 elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure who were admitted to our hospital from January 2016 to December 2019 were selected as the research subjects,and they were divided into the control group and the analysis group according to the red and blue number drawing method,with 36 cases in each group.The control group was given non-invasive positive pressure ventilation,and the analysis group was given nasal high-flow oxygen therapy combined with non-invasive positive pressure ventilation.The clinical efficacy,incidence of adverse reactions,respiratory mechanics indexes,and pulmonary function indexes before and after treatment were compared between the two groups.Results The total effective rate in the analysis group was 94.44%,which was higher than 77.78%in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the analysis group was 8.33%,which was lower than 27.78%in the control group,and the difference was statistically significant(P<0.05).After treatment,the tidal volume(VT),minute ventilation(MV)in the analysis group were greater than those in the control group,while the rapid shallow breathing index(RSBI)was lower than that in the control group,and inspiratory time(Ti)was shorter than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the forced vital capacity(FVC),forced expiratory volume at one second(FEV_(1))and peak expiratory flow(PEF)in the two groups were higher than those before treatment,and the analysis group was significantly higher than the control group,and the difference was statistically significant(P<0.05).Conclusion Nasal high-flow oxygen therapy combined with non-invasive positive pressure ventilation in the treatment of elderly chronic obstructive pulmonary disease complicated with respiratory failure has significant effect,which can not only rapidly adjust the levels of respiratory mechanics and pulmonary function indicators,but also has low incidence of adverse reactions and high treatment safety,which is worthy of clinical promotion and application.
作者
瞿礼强
QU Liqiang(Department of General Internal Medicine,Haimen Third People's Hospital,Nantong,Jiangsu,226153,China)
出处
《当代医学》
2022年第27期168-171,共4页
Contemporary Medicine
关键词
经鼻高流量氧疗
无创正压通气
老年慢阻肺合并呼吸衰竭
呼吸力学指标
Nasal high-flow oxygen therapy
Non-invasive positive pressure ventilation
Elderly chronic obstructive pulmonary disease complicated with respiratory failure
Respiratory mechanics indexes
