非诺考昔（NFNC）治疗慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者的临床研究
Clinical study of NFNC in the treatment of acute exacerbation chronic obstructive pulmonary disease patients with respiratory failure.
作者信息
Chen Xiang, Dai Ling, Ma Jin-Zhu, Chu Xin-Xu, Dai Liang, Liu Jian-Ming, Guo Si-Wei, Ru Xin-Wei, Zhuang Xue-Shi
机构信息
Pulmonary and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan 430000, Hubei Province, China.
Department of Intensive Care Second Unit, Wuhan No. 1 Hospital, Wuhan 430000, Hubei Province, China.
出版信息
World J Clin Cases. 2023 Nov 16;11(32):7770-7777. doi: 10.12998/wjcc.v11.i32.7770.
BACKGROUND
Most patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment. High flow nasal cannula (HFNC) oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state, reduces dead space ventilation and breathing effort, protects the loss of cilia in the airways, and improves patient comfort.
AIM
To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.
METHODS
Eighty AECOPD patients were included in the study. The patients were in the intensive care department of our hospital from October 2019 to October 2021. The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group. Differences in patient comfort, blood gas analysis and infection indices were analyzed between the two groups.
RESULTS
After treatment, symptoms including nasal, throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3 and 5 days ( < 0.05). Before treatment, the PaO, PaO/FiO, PaCO, and SaO in the two groups of patients were not significantly different ( > 0.05). After treatment, the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group ( < 0.05). After treatment, the white blood cell count, and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group ( < 0.05).
CONCLUSION
HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort, and reducing complications. HFNC is a clinically valuable technique for the treatment of AECOPD.
背景
大多数慢性阻塞性肺疾病急性加重期（AECOPD）患者存在呼吸衰竭，需要积极纠正，治疗期间改善氧合尤为重要。高流量鼻导管（HFNC）氧疗是一种非侵入性呼吸辅助手段，在临床上广泛应用，可改善氧合状态、减少死腔通气和呼吸做功、保护气道纤毛丧失并提高患者舒适度。
目的
比较HFNC与无创正压通气治疗AECOPD患者的效果。
方法
本研究纳入80例AECOPD患者。这些患者于2019年10月至2021年10月在我院重症监护室。根据不同治疗方法将患者分为对照组和治疗组，每组40例。分析两组患者舒适度、血气分析及感染指标的差异。
结果
治疗后，治疗组在第3天和第5天的鼻、喉和胸部不适等症状明显低于对照组（P < 0.05）。治疗前，两组患者的PaO₂、PaO₂/FiO₂、PaCO₂和SaO₂差异无统计学意义（P > 0.05）。治疗后，两组患者的上述指标均显著改善，但治疗组改善程度大于对照组（P < 0.05）。治疗后，治疗组患者的白细胞计数、C反应蛋白水平和降钙素水平均显著高于对照组患者（P < 0.05）。
结论
HFNC治疗可改善AECOPD患者的通气，同时提高患者舒适度并减少并发症。HFNC是治疗AECOPD的一项具有临床价值的技术。
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