| 张 鑫,吕建农,张海燕,高 鹏,巩玉菊.经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期患者血气指标、膈肌功能及炎性反应的影响[J].,2021,(24):4737-4741 |
| 经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期患者血气指标、膈肌功能及炎性反应的影响 |
| Effects of Nasal High Flow Oxygen Therapy on Blood Gas Index, Diaphragm Function and Inflammatory Reaction in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| 投稿时间：2021-04-26 修订日期：2021-05-23 |
| DOI：10.13241/j.cnki.pmb.2021.24.028 |
| 中文关键词: 经鼻高流量氧疗 慢性阻塞性肺疾病急性加重期 血气指标 膈肌功能 炎性反应 |
| 英文关键词: Nasal high flow oxygen therapy Acute exacerbation of chronic obstructive pulmonary disease Blood gas index Diaphragm function Inflammatory reaction |
| 基金项目:江苏省卫生健康委科研项目（H2019090） |
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| 中文摘要: |
| 摘要 目的：探讨经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期（AECOPD）患者血气指标、膈肌功能及炎性反应的影响。方法：回顾性分析2018年2月~2020年8月我院收治的119例AECOPD患者的临床资料。根据不同氧疗方法分为传统组59例和研究组60例，传统组给予传统氧疗，研究组给予经鼻高流量氧疗。对比两组治疗前后血气指标、膈肌功能及炎性反应的变化情况，观察两组不良反应发生率、治疗后再插管率、喘急胸闷和咳痰困难消失率。结果：研究组治疗后动脉血二氧化碳分压（PaCO2） 较传统组低，血氧饱和度（SaO2）、动脉血氧分压（PaO2）高于传统组（均P<0.05）。研究组治疗后膈肌浅快呼吸指数（D-RSBI）、平静呼吸膈肌移动度（DEq）低于传统组（均P<0.05）。研究组治疗后血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α 低于传统组（均P<0.05）。研究组治疗后再插管率低于传统组，喘急胸闷消失率、咳痰困难消失率高于传统组（均P<0.05）。两组的不良反应总发生率组间对比无统计学差异（P>0.05）。结论：与传统氧疗相比，经鼻高流量氧疗应用于AECOPD患者可有效改善血气指标、膈肌功能，减轻炎性反应，改善患者的临床症状。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of nasal high flow oxygen therapy on blood gas index, diaphragm function and inflammatory reaction in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: The clinical data of 119 patients with AECOPD in our hospital from February 2018 to August 2020 were retrospectively analyzed. According to different oxygen therapy methods, they were divided into traditional group with 59 cases and study group with 60 cases. The traditional group was treated with traditional oxygen therapy, and the study group was treated with nasal high flow oxygen therapy. The changes of blood gas index, diaphragm function and inflammatory reaction were compared between the two groups before and after treatment. The incidence of adverse reactions, reintubation rate after treatment, disappearance rate of dyspnea and chest tightness, expectoration difficulty were observed. Results: Arterial blood carbon dioxide partial pressure (PaCO2) in the study group after treatment was lower than that in the traditional group, blood oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2) were higher than those in the traditional group (all P<0.05). After treatment, diaphragm shallow fast respiration index (D-RSBI), diaphragm movement of calm breathing (DEq) in the study group were lower than those in the traditional group (all P<0.05). After treatment, the levels of serum interleukin (IL)-6, tumor necrosis factor (TNF)-α in the study group were lower than those in the traditional group (all P<0.05). The reintubation rate in the study group after treatment was lower than that in the traditional group, and the disappearance rate of dyspnea, chest tightness and the disappearance rate of expectoration difficulty in the study group were higher than those in the traditional group (all P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion: Compared with traditional oxygen therapy, nasal high flow oxygen therapy in patients with AECOPD can effectively improve blood gas indexes, diaphragm function, reduce inflammatory response, and improve the clinical symptoms of patients. |
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