无创机械通气与拔管后经鼻高流量氧疗对治疗慢性阻塞性肺疾病急性加重血气指标的影
Effects of noninvasive mechanical ventilation vs. nasal high flow oxygen therapy following extubation on blood gas index in AECOPD

陈喆.无创机械通气与拔管后经鼻高流量氧疗对治疗慢性阻塞性肺疾病急性加重血气指标的影[J].内科急危重症杂志,2019,25(1):38-40

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DOI：10.11768/nkjwzzzz20190112

中文关键词: 无创机械通气高流量氧疗慢性阻塞性肺疾病急性加重期血气指标肺功能

英文关键词:

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作者	单位	E-mail
陈喆	北京市海淀医院	cz7902zc@163.com

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中文摘要:

目的：探讨无创机械通气与拔管后序贯经鼻高流量氧疗对治疗慢性阻塞性肺疾病急性加重血气指标的影响。方法：选取 AECOPD患者122例，根据随机信封抽签原则分为观察组与对照组，各61例，对照组采用无创机械通气治疗，观察组给予拔管后序贯经鼻高流量氧疗，记录2组疗效与血气指标变化。结果：治疗后观察组总有效率显著高于对照组(98.3% vs 88.5%,P<0.05)。治疗后2组的PaO2值明显上升，PaCO2值明显下降 (均P<0.05)，且观察组明显优于对照组(均P<0.05)。治疗后2组的用力肺活量（FVC）与第1秒用力呼吸容积（FEV1）都明显升高(均P<0.05)，且观察组明显优于对照组(均P<0.05)。观察组的呼吸机使用时间、住院时间明显少于对照组(均P<0.05)。2组的腹胀、鼻损伤等并发症发生率无明显差异(均P>0.05)。结论：拔管后序贯经鼻高流量氧疗能改善AECOPD患者的血气指标，提高肺功能及总体疗效，促进患者康复，且不会增加并发症的发生。

英文摘要:

Objective: To investigate the effects of noninvasive mechanical ventilation vs. nasal high flow oxygen therapy following extubation on the blood gas index in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: 122 cases of AECOPD were selected as the research objects, and divided into observation group and control group with 61 cases in each group according to the order of admission and the principle of random envelope drawing. The control group was given the noninvasive mechanical ventilation treatment, and the observation group was given nasal high flow oxygen therapy after extubation. The effectiveness and the blood gas changes were recorded in the two groups. Results: After treatment, the total effective rate in the observation group and the control group was 98.3% and 88.5% respectively (P<0.05). After treatment, the PaO2 values in the two groups increased significantly, and PaCO2 values were decreased significantly (P<0.05), and there was significant difference in PaO2 and PaCO2 values between two groups (P<0.05). After treatment, FVC and FEV1 values in both groups were significantly higher than those before treatment (P<0.05), and those in the observation group after treatment were also significantly higher than in the control group (P<0.05). The ventilator use time and length of hospital stay in the observation group were significantly shorter than those in the control group (P<0.05). There was no significant difference in abdominal distension, nose injury and other complications between two groups (P>0.05). Conclusion: The nasal high flow oxygen therapy after extubation in the treatment of AECOPD can improve the blood gas index, lung function and the overall treatment effects, promote the rehabilitation of patients, and will not increase the complications.