摘要
目的探讨经鼻高流量湿化氧疗(HFNC)作为气道廓清技术(ACT)的辅助手段在慢性阻塞性肺疾病急性加重(AECOPD)患者中的应用价值。方法前瞻性纳入2024年1月至2025年2月温州市中西医结合医院收治的80例AECOPD患者,采用信封法随机分为观察组和对照组,每组40例。对照组采用西药常规治疗联合胸廓高频震荡技术(HFCWC)及普通氧疗的治疗方案,观察组采用西药常规治疗联合HFCWC及HFNC的治疗方案。比较两组患者治疗前后排痰情况、肺功能指标[第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1占FVC的百分比(FEV1/FVC)]、AECOPD症状严重程度[采用慢性阻塞性肺疾病评估测试(CAT)评分评估]。结果治疗后观察组患者排痰情况优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FEV1、FVC、FEV1/FVC均高于治疗前,且观察组均高于对照组,差异均有统计学意义(均P<0.05)。治疗后两组患者CAT评分低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。结论HFNC作为ACT的辅助手段可提升AECOPD患者肺功能水平,改善患者排痰情况,减轻疾病严重程度。
Objective To investigate the application value of high-flow nasal cannula(HFNC)as an adjunct to airway clearance techniques(ACT)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A prospective study was conducted,enrolling 80 AECOPD patients admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2024 to February 2025.Patients were randomly divided into an observation group and a control group using the envelope method,with 40 patients in each group.The control group received conventional Western medicine treatment combined with high-frequency chest wall compression(HFCWC)and standard oxygen therapy,while the observation group received conventional Western medicine treatment combined with HFCWC and HFNC.Sputum expectoration,pulmonary function parameters[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and the ratio of FEV1 to FVC(FEV1/FVC)],and AECOPD symptom severity[assessed using the Chronic Obstructive Pulmonary Disease Assessment Test(CAT)score]were compared between the two groups before and after treatment.Results After treatment,the observation group showed significantly better sputum expectoration than the control group(P<0.05).Both groups exhibited significant increases in FEV1,FVC,and FEV1/FVC after treatment compared to baseline,with the observation group demonstrating higher values than the control group(all P<0.05).The CAT scores of both groups decreased significantly after treatment,with the observation group showing a lower score than the control group(all P<0.05).Conclusion HFNC,as an adjunct to ACT,can improve pulmonary function,enhance sputum clearance,and reduce disease severity in patients with AECOPD.
作者
蒋欢欢
陈琼琰
葛金林
金晨慈
JIANG Huanhuan;CHEN Qiongyan;GE Jinlin;JIN Chenci(Department of Respiratory and Critical Care Medicine,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou 325000,China)
出处
《浙江医学》
2026年第2期177-181,共5页
Zhejiang Medical Journal
基金
温州市基础性科研项目(Y2023406)。
关键词
慢性阻塞性肺疾病急性加重
胸廓高频振荡技术
经鼻高流量湿化氧疗
气道廓清技术
Acute exacerbation of chronic obstructive pulmonary disease
High-frequency chest wall compression
High-flow nasal cannula
Airway clearance technique
