摘要
目的 探究不同流速经鼻高流量氧疗(HFNC)在支气管哮喘急性发作合并Ⅰ型呼吸衰竭患者中的急救效果。方法 前瞻性选取2020年8月—2023年5月在内江市第一人民医院治疗的84例支气管哮喘急性发作合并Ⅰ型呼吸衰竭患者,采用随机数字表法分为低流速组(n=42,常规治疗+30 L/min流速HFNC治疗)和高流速组(n=42,常规治疗+50 L/min流速HFNC治疗),比较两组急救疗效、临床症状消失时间以及治疗前后血气分析指标[pH值、氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]、呼吸频率水平、呼吸困难程度和呼吸舒适度。结果 高流速组急救总有效率(95.24%)高于低流速组(80.95%)(χ^(2)=4.086,P<0.05);高流速组患者临床症状消失时间短于低流速组相(P<0.05);治疗1 h,高流速组呼吸频率低于低流速组(t=4.432,P<0.05);治疗后,与低流速组相比,高流速组患者PaCO_(2)水平、呼吸困难程度评分更低,呼吸舒适度评分、PaO_(2)水平更高(t=3.037、4.263、6.546、5.865,P<0.05)。结论 相比低流速HFNC,高流速HFNC治疗支气管哮喘急性发作合并Ⅰ型呼吸衰竭患者急救有效率更高,临床症状消失更快,血气指标改善更加明显,且对患者呼吸舒适度、呼吸困难程度以及呼吸频率也有影响。
Objective To explore the emergency effect of high-flow nasal cannula oxygen therapy(HFNC)at different flow rates on patients with acute attack of bronchial asthma complicated with type Ⅰ respiratory failure.Methods 84 patients with acute attack of bronchial asthma complicated with type Ⅰ respiratory failure who were treated in the First People’s Hospital of Neijiang were prospectively selected from August 2020 to May 2023,and were divided into low flow rate group(n=42,conventional treatment+30 L/min flow rate HFNC treatment)and high flow rate group(n=42,conventional treatment+50 L/min flow rate HFNC treatment)by adopting random number table method.The emergency efficacy,disappearance durations of clinical symptoms,as well as blood gas analysis indicators[pH value,partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))],respiratory rate level,respiratory distress degree and respiratory comfort degree before and after treatment were compared between both groups.Results The total effective rate of emergency in the high flow rate group(95.24%)was higher than that in the low flow rate group(80.95%)(χ^(2)=4.086,P<0.05).The disappearance durations of clinical symptoms in the high flow rate group were shorter compared to the low flow rate group(P<0.05).After 1 hour of treatment,the respiratory rate in the high flow rate group was lower than that in the low flow rate group(t=4.432,P<0.05).After treatment,compared with the low flow rate group,the PaCO_(2) and respiratory distress score of patients in the high flow rate group were lower while the respiratory comfort score and PaO_(2) were higher(t=3.037,4.263,6.546,5.865,P<0.05).Conclusion Compared with HFNC at low flow rate,HFNC at high flow rate for patients with acute attack of bronchial asthma complicated with type I respiratory failure has higher emergency effective rate,faster clinical symptom disappearance and more obviously improved blood gas indicators,but it can affect the respiratory comfort degree,respiratory distress and respiratory rate.
作者
刘艳
曾薪月
李丹
LIU Yan;ZENG Xinyue;LI Dan(Department of Critical Care Medicine,the First People's Hospital of Neijiang,Neijiang Sichuan 641000,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第8期1067-1070,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川省卫生健康委员会普及应用项目(20PJ290)。
关键词
支气管哮喘急性发作
Ⅰ型呼吸衰竭
流速
经鼻高流量氧疗
Acute attack of bronchial asthma
Type I respiratory failure
Flow rate
High-flow nasal cannula oxygen therapy
