摘要
目的:比较加温湿化高流量鼻导管氧疗(HHHFNC)与无创正压通气在重症肺炎合并Ⅰ型呼吸衰竭患者中的应用效果。方法:选取2021年1月至2022年9月该院收治的124例重症肺炎合并Ⅰ型呼吸衰竭患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各62例。两组均进行常规药物治疗,在此基础上,对照组采用无创正压通气进行呼吸支持,研究组采用HHHFNC进行呼吸支持,比较两组临床症状(发绀、呼吸困难、肺部啰音)消失时间、治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、每分钟最大通气量(MVV)]水平、动脉血氧饱和度(SaO_(2))和血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平。结果:研究组发绀、呼吸困难、肺部啰音等临床症状消失时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组FEV_(1)、MVV和SaO_(2)水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组TNF-α和IL-6水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论:HHHFNC用于重症肺炎合并Ⅰ型呼吸衰竭患者可缩短其临床症状消失时间,提高其FEV_(1)、MVV、SaO_(2)水平,降低其炎性因子水平,效果优于无创正压通气。
Objective:To compare effects of high-flow nasal catheter warming humidification oxygen therapy(HHHFNC)and noninvasive positive pressure ventilation in patients with severe pneumonia complicated with type I respiratory failure.Methods:A prospective study was conducted on 124 patients with severe pneumonia complicated with type I respiratory failure admitted to this hospital from January 2021 to September 2022.They were divided into study group and control group according to the random number table method,62 cases in each group.Both groups of patients were treated with conventional drugs.On this basis,the control group was treated with noninvasive positive pressure ventilation for respiratory support,while the study group was treated with HHHFNC.The disappearance time of clinical symptoms(cyanosis,dyspnea,pulmonary rales),the lung function indexes levels[forced expiratory volume in one second(FEV_(1)),maximum ventilation volume per minute(MVV)],the arterial oxygen saturation(SaO_(2)),and the serum inflammatory factor levels[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]were compared between the two groups.Results:The disappearance time of clinical symptoms such as cyanosis,dyspnea and pulmonary rales in the study group was shorter than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of pulmonary function indexes such as FEV_(1)and MVV and SaO_(2)in the two groups were higher than those before the treatment,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the levels of TNF-αand IL-6 in the two groups were lower than those before treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:HHHFNC can shorten the disappearance time of clinical symptoms,improve the levels of FEV_(1),MVV and SaO_(2),and reduce the levels of inflammatory factors in the patients with severe pneumonia complicated with type I respiratory failure.Moreover,it is superior to noninvasive positive pressure ventilation.
作者
王利兵
WANG Libing(Department of Critical Care Medicine of Loudi Central Hospital,Loudi 417000 Hunan,China)
出处
《中国民康医学》
2023年第23期165-167,共3页
Medical Journal of Chinese People’s Health
关键词
重症肺炎
呼吸衰竭
高流量鼻导管加温湿化氧疗
无创正压通气
肺功能
炎性因子
临床症状
Severe pneumonia
Respiratory failure
High-flow nasal catheter warming humidification oxygen therapy
Noninvasive positive pressure ventilation
Lung function
Inflammatory factor
Clinical symptom
