摘要
目的 探究经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能、呼吸肌及预后的影响.方法 选择122例AECOPD患者,且均于2020年10月至2022年10月在我院诊治,将其随机均分为对照组和观察组.对照组采用无创正压通气治疗,观察组采用经鼻高流量吸氧治疗.比较两组肺功能、呼吸肌功能、炎性反应指标、再插管率、住院时长及不良反应发生情况.结果 治疗后,观察组第 1秒用力呼气容积(FEV1)、第1秒用力呼气量占预计值百分比(FEV1％)较对照组高(P＜0.05).两组患者治疗后D-RSBI、DEq均降低(P＜0.05),观察组D-RSBI、DEq较对照组更低(P＜0.05).观察组较对照组住院时间更短、再插管率更低(P＜0.05).两组患者治疗后血清CRP、IL-6、PCT水平均降低(P＜0.05),观察组较对照组更低(P＜0.05).两组不良反发生情况组间比较差异无统计学意义(P＞0.05).结论 经鼻高流量氧疗可显著改善患者肺功能、呼吸肌功能,降低炎性指标、再插管率和缩短住院时间,使患者获得更良好的预后.
Abstract
Objective To explore the effect of high-flow nasal cannula oxygen therapy on pulmonary function,respirato-ry muscle activity,and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods One hundred and twenty-two AECOPD patients in our hospital from October 2020 to October 2022 were en-rolled,and randomly assigned into two groups according to random number table methods,each with 61 cases.Control group received non-invasive positive pressure ventilation,while observation group adopted high-flow nasal cannula oxygen therapy.The pulmonary function,respiratory muscle function,inflammatory cytokines,re-intubation rate,length of stay,and adverse reactions of two groups were compared.Results After treatment,the values of forced expiratory volume in 1 second(FEV1)and percent predicted of forced expiratory volume in first second(FEV1％)in observation group were larger than those in control group(P＜0.05).There was a decrease in diaphragmatic-rapid shallow breathing index(D-RSBI)and dia-phragmatic excursions during quiet breathing(DEq)in both groups after treatment(P＜0.05),and the two respiratory mus-cle function parameters were notably decreased in observation group compared with control group(P＜0.05).Compared with control group,observation group had decreased time to length of stay and lower re-intubation rate,with statistical differ-ence(P＜0.05).A reduction in C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)was observed in both groups after treatment(P＜0.05),and the three inflammation factors were notably lower in observation group than in control group(P＜0.05).The adverse reaction rate yielded no statistical difference between two groups(P＞0.05).Con-clusion Application of high-flow nasal cannula oxygen therapy in AECOPD can effectively improve the pulmonary func-tion,respiratory function,attenuate the inflammation response,reduce re-intubation rate,and decrease the length of stay,thus improving the prognosis of patients.
维普
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