目的:分析HFNC(高流量氧治疗)联合呼吸兴奋剂治疗慢性阻塞性肺病(简称慢阻肺)急性加重(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭的临床效果。方法:选取2018年5月至2019年5月收治的150例慢阻肺急性加重合并Ⅱ型呼吸衰竭患者,随机分为呼吸兴奋剂组、联合组、HFNC组;呼吸兴奋剂组患者进行呼吸兴奋剂治疗,联合组患者进行HFNC联合呼吸兴奋剂治疗,HFNC组仅进行HFNC治疗;比较3组患者的临床疗效,治疗前后患者的心率、呼吸频率、动脉血气、肺功能。结果:联合组患者的临床疗效总有效率为90.00%,较呼吸兴奋剂组、HFNC组高(P<0.05);治疗前3组患者的心率、呼吸频率、PaO2、PaCO2、pH值、FEV1、FEV1/FVC相比,差异无统计学意义(P>0.05);治疗后(24 h、72 h、7 d)3组患者的心率、呼吸频率、PaCO2均降低(P<0.05),PaO2、PH、FEV1、FEV1/FVC均上升(P<0.05),且治疗后(24 h、72 h、7 d)联合组患者心率、呼吸频率下降更多(P<0.05),PaO2、FEV1、FEV1/FVC上升更多,PaCO2降低更多(P<0.05)。结论:HFNC联合呼吸兴奋剂治疗慢阻肺急性加重合并Ⅱ型呼吸衰竭可提高临床疗效,降低患者心率、呼吸频率,改善肺功能,促进疾病康复,建议在临床上推广。
Objective:To investigate the clinical effects of HFNC(high-flow oxygen therapy)combined with respiratory stimulant in the treatment of AECOPD with type II respiratory failure.Methods:150 patients with AECOPD and type II respiratory failure admitted from May 2018 to May 2019 were selected and divided into groups A,B and C randomly.Group A was given respiratory stimulant treatment,group B was given HFNC combined with respiratory stimulant,and group C was given only HFNC treatment.Results:The total effective rate of clinical efficacy in group B was 90.00%,which was significantly higher than that in group A and C(P<0.0167).There was no significant difference in heart rate,respiratory rate,PaO2,PaCO2,PH value,FEV1 and FEV1/FVC between the three groups before treatment(P>0.05),after treatment(24 h,72 h,7 d),the heart rate,respiratory rate and PaCO2 were decreased,PaO2,PH,FEV1,FEV1/FVC were all increased after treatment(24 h,72 h,7 d).The heart rate and respiratory rate of group B decreased more significantly(P<0.05),PaO2,FEV1,FEV1/FVC increased more significantly,and PaCO2 decreased more significantly(P<0.05).Conclusion:HFNC combined with respiratory stimulant treatment of AECOPD combined with type II respiratory failure can significantly improve clinical efficacy,reduce heart rate,reduce respiratory rate,improve oxygenation and lung function,and promote disease recovery.It is recommended to be clinically popularized.
Journal of Baotou Medical College
High-flow oxygen therapy
Acute exacerbation of chronic obstructive pulmonary disease
Type II respiratory failure