经鼻高流量湿化氧疗治疗AECOPD合并Ⅱ型呼吸衰竭的效果观察

宋运远 李德烈 谭运宝 王小龙 刘民军 付鸿雁

广东省人民医院赣州医院/赣州市立医院

摘要：目的：探讨经鼻高流量湿化氧疗（HFNC）治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的效果。方法：选取94例AECOPD合并Ⅱ型呼吸衰竭患者，按随机数字表法分为两组，每组各47例。对照组行无创正压通气（NIPPV）治疗，观察组行HFNC治疗，比较治疗后两组通气效果。结果：治疗后，观察组血氧分压（PaO2）较对照组高，二氧化碳分压（PaCO2）较对照组低，观察组第1秒用力呼气容积（FEV1）、用力肺活量（FVC）及FEV1/FVC较对照组高，呼吸支持时间、呼吸困难缓解时间及住院时间较对照组短（P＜0.05）;观察组并发症发生率比对照组低（P＜0.05）。结论：HFNC治疗可减轻AECOPD伴Ⅱ型呼吸衰竭患者肺损伤，加快动脉血气复常，缩短呼吸支持时间，减少并发症发生。

关键词：慢性阻塞性肺疾病;Ⅱ型呼吸衰竭;经鼻高流量湿化氧疗;无创正压通气;

Effect of high-flow nasal cannula humidified oxygen therapy on AECOPD patients complicated with typeⅡrespiratory failure

SONG Yunyuan,LI Delie,TAN Yunbao,WANG Xiaolong,LIU Minjun,FU Hongyan.(Guangdong Provincial People′s Hospital Ganzhou Hospital / Ganzhou Municipal Hospital,Ganzhou 341000,China)

Abstract Objective: To investigate the effect of high-flow nasal cannula ( HFNC) humidified oxygen therapy in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type Ⅱ respiratory failure. Methods: A total of 94 AECOPD patients complicated with type Ⅱ respiratory failure were randomized into two groups, each with 47 cases. The control group received non-invasive positive pressure ventilation(NIPPV) treatment, while the observation group received HFNC treatment. Then the ventilation effects were compared between both groups. Results: After treatment, PaO2in the observation group was higher than that in the control group, and PaCO2 was lower than that in the control group (P< 0. 05); forced expiratory volume in the first second ( FEV1), forced vital capacity(FVC), and FEV1 / FVC was higher than that in the control group; the respiratory support time, time for relief of dyspnea and hospital duration was shorter than that of the control group (P<0.05); and the complication rate of the observation group was lower than that of the control group (P<0.05). Conclusion: For AECOPD patients complicated with type Ⅱ respiratory failure, HFNC therapy can reduce lung injury, accelerate the normalization of arterial blood gas, shorten the time of respiratorysupport, and reduce the occurrence of complications.

Keywords:chronic obstructive pulmonary disease(COPD); type Ⅱ respiratory failure; high-flow nasal cannula(HFNC) humidified oxygen therapy; non-invasive positive pressure ventilation(NIPPV)

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