经鼻高流量氧疗治疗超高龄急性低氧性呼吸衰竭患者的临床研究(1)
[摘要] 目的 探讨经鼻高流量氧疗(HFNC)治疗超高龄急性低氧性呼吸衰竭(AHRF)患者的临床疗效。 方法 选取2016年3月～2020年3月本院綜合老年病房救治的76例高龄AHRF患者，年龄均≥90岁，分为HFNC组和常规吸氧组，每组各38例。HFNC组给予HFNC治疗，常规吸氧组给予鼻导管常规给氧治疗。观察两组治疗前和治疗6 h后呼吸频率(RR)、动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、血氧饱和度(SpO2)变化，统计两组治疗期间并发症发生率或气管切开率。 结果 与本组治疗前比较，两组治疗6 h后PaO2、SpO2水平升高，RR下降，差异有统计学意义(P<0.05);组间治疗6 h比较，HFNC组PaO2、SpO2水平高于常规吸氧组，RR水平低于常规吸氧组，差异有统计学意义(P<0.05);HFNC组总有效率为(97.37%)明显高于常规吸氧组的(78.95%)，总并发症发生率的(13.16%)显著低于常规吸氧组的(34.21%)，差异有统计学意义(χ2=4.537、4.659，P<0.05);两组气管插管或气管切开率比较，差异无统计学意义(P>0.05)。 结论 HFNC能明显改善超高龄AHRF患者低氧状态，且并发症少，临床应用优势显著。
[关键词] 急性低氧性呼吸衰竭;超高龄;经鼻高流量氧疗;低氧状态;并发症
[中图分类号] R563.8 [文献标识码] B [文章编号] 1673-9701(2020)30-0108-04
Clinical study of high-flow nasal cannula oxygen in the treatment of acute hypoxic respiratory failure in extremely old patients
ZHANG Yifei1 WU Yuanhe2 YANG Ping1
1.Ward 1 of Department of Integrated Geriatrics， Jinqiu Hospital of Liaoning Province， Shenyang 110016， China; 2.Department of Blood Purification， the General Hospital of Shenyang Military Region， Shenyang 110015， China
[Abstract] Objective To investigate the clinical efficacy of high-flow nasal cannula (HFNC) oxygen in the treatment of acute hypoxic respiratory failure(AHRF) in extremely old patients. Methods A total of 76 extremely old AHRF patients， all ≥ 90 years old， admitted to department of integrated geriatrics in our hospital from March 2016 to March 2020 were selected and divided into the HFNC oxygen group(n=38) and the conventional oxygen group(n=38) according to the random number table method. The HFNC group was treated with HFNC， while the conventional oxygen group was treated with conventional nasal cannula. Respiratory rate(RR)， arterial oxygen pressure(PaO2)， arterial carbon dioxide pressure(PaCO2)， and blood oxygen saturation(SpO2) were observed before and 6 h after treatment in the two groups， and the complication rate and tracheal cannula rate or tracheotomy were calculated. Results Compared with before treatment， the levels of PaO2 and SpO2 increased and the level of RR decreased at 6 h after treatment in the two groups， with significant differences(P<0.05). At 6 h after treatment， the levels of PaO2 and SpO2 were higher and the level of RR was lower than those in the conventional oxygen group， with significant differences(P<0.05). The total effective rate of HFNC group(97.37%) and the total complication rate(13.16%) were significantly higher and lower than those of conventional oxygen group(78.95%)(34.21%)(χ2=4.537， 4.659， P<0.05)， respectively. There were no significant differences intracheal cannula rate or tracheotomy between the two groups(P>0.05). Conclusion HFNC can significantly improve the hypoxia status of extremely old AHRF patients， with fewer complications and significant clinical application advantages., http://www.100md.com(张毅斐 武元赫 杨萍)
[关键词] 急性低氧性呼吸衰竭;超高龄;经鼻高流量氧疗;低氧状态;并发症
[中图分类号] R563.8 [文献标识码] B [文章编号] 1673-9701(2020)30-0108-04
Clinical study of high-flow nasal cannula oxygen in the treatment of acute hypoxic respiratory failure in extremely old patients
ZHANG Yifei1 WU Yuanhe2 YANG Ping1
1.Ward 1 of Department of Integrated Geriatrics， Jinqiu Hospital of Liaoning Province， Shenyang 110016， China; 2.Department of Blood Purification， the General Hospital of Shenyang Military Region， Shenyang 110015， China
[Abstract] Objective To investigate the clinical efficacy of high-flow nasal cannula (HFNC) oxygen in the treatment of acute hypoxic respiratory failure(AHRF) in extremely old patients. Methods A total of 76 extremely old AHRF patients， all ≥ 90 years old， admitted to department of integrated geriatrics in our hospital from March 2016 to March 2020 were selected and divided into the HFNC oxygen group(n=38) and the conventional oxygen group(n=38) according to the random number table method. The HFNC group was treated with HFNC， while the conventional oxygen group was treated with conventional nasal cannula. Respiratory rate(RR)， arterial oxygen pressure(PaO2)， arterial carbon dioxide pressure(PaCO2)， and blood oxygen saturation(SpO2) were observed before and 6 h after treatment in the two groups， and the complication rate and tracheal cannula rate or tracheotomy were calculated. Results Compared with before treatment， the levels of PaO2 and SpO2 increased and the level of RR decreased at 6 h after treatment in the two groups， with significant differences(P<0.05). At 6 h after treatment， the levels of PaO2 and SpO2 were higher and the level of RR was lower than those in the conventional oxygen group， with significant differences(P<0.05). The total effective rate of HFNC group(97.37%) and the total complication rate(13.16%) were significantly higher and lower than those of conventional oxygen group(78.95%)(34.21%)(χ2=4.537， 4.659， P<0.05)， respectively. There were no significant differences intracheal cannula rate or tracheotomy between the two groups(P>0.05). Conclusion HFNC can significantly improve the hypoxia status of extremely old AHRF patients， with fewer complications and significant clinical application advantages., http://www.100md.com(张毅斐 武元赫 杨萍)