老年COPD合并呼吸衰竭患者HFNC治疗效果及CT参数变化分析

doi:10.7517/issn.1674-0475.220513

影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (5): 1195-1199.DOI: 10.7517/issn.1674-0475.220513

老年COPD合并呼吸衰竭患者HFNC治疗效果及CT参数变化分析

梁金排¹, 赵红玲¹, 张冰¹, 刘淑红¹, 肖翠君¹, 闫锡新², 柴书坤³, 刘莉⁴

1. 衡水市人民医院老年病二科, 河北衡水 053000;
2. 河北医科大学第二医院呼吸内科, 河北石家庄 050000;
3. 石家庄市第一医院呼吸内科, 河北石家庄 050000;
4. 河北医科大学第一医院内分泌科, 河北石家庄 050000

收稿日期:2022-05-27 发布日期:2022-09-13
通讯作者: 肖翠君
基金资助:
河北省医学科学研究课题（20191786）

Analysis of HFNC Therapeutic Effect and CT Parameters Changes in Elderly COPD Patients Complicated with Respiratory Failure

LIANG Jinpai¹, ZHAO Hongling¹, ZHANG Bing¹, LIU Shuhong¹, XIAO Cuijun¹, YAN Xixin², CHAI Shukun³, LIU Li⁴

1. Department of Second Geriatrics, Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China;
2. Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, P. R. China;
3. Department of Respiratory Medicine, Shijiazhuang First Hospital, Shijiazhuang 050000, Hebei, P. R. China;
4. Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, P. R. China

Received:2022-05-27 Published:2022-09-13

摘要/Abstract

摘要： 本文探讨老年慢性阻塞性肺疾病（COPD）合并呼吸衰竭患者采用经鼻高流量加温湿化吸氧（HFNC）治疗效果及治疗前后CT定量参数的变化。选取200例慢性阻塞性肺疾病急性加重期（AECOPD）合并轻度呼吸衰竭患者作为研究对象，按随机数字表法分为治疗组和对照组，每组100例。均给予无创通气治疗，在此基础上治疗组患者采用HFNC方式治疗，对照组采用低流量氧疗，对比两组患者治疗前后血气参数、最大吸气末异常容积（Cvin）、最大呼气末异常容积（Cvex）、肺体积、肺横径等CT定量参数，并对比两组治疗效果。治疗72 h后，治疗组患者的PaO₂、PaO₂/FiO₂、SaO₂测定值高于对照组，治疗组患者的PaCO₂测定值低于对照组，差异均具有统计学意义（P<0.05）；治疗后，治疗组患者的Cvin、Cvex、肺横径、LAA%-950insp、LAA%-856exp测定值低于对照组（P<0.05）；治疗后，治疗组患者的CAT评分、mMRC评分低于对照组（P<0.05）；治疗1周后，治疗组的治疗有效率高于对照组（P<0.05）。经鼻HFNC治疗COPD合并呼吸衰竭患者效果显著，CT肺部扫描可有效观察经鼻HFNC治疗前后的肺功能变化，对于评估临床治疗效果具有重要意义。

关键词: 慢性阻塞性肺疾病, 呼吸衰竭, 无创通气, 经鼻高流量加温湿化吸氧, 计算机断层扫描

Abstract: This study investigated the changes and effects of CT quantitative parameters in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure before and after nasal high flow humidification oxygen inhalation (HFNC). 200 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with mild respiratory failure were randomly divided into two groups with 100 cases in each group. All patients were received non-invasive ventilation, and on the basis the patients in the treatment group were treated with HFNC, and the patients in the control group were treated with low flow oxygen therapy. The blood gas parameters, maximum abnormal end inspiratory volume (Cvin), maximum abnormal end expiratory volume (Cvex), lung volume, lung transverse diameter and other CT quantitative parameters of the two groups were compared before and after treatment, and the treatment effects of the two groups were compared. After 72 hours of treatment, the PaO₂, PaO₂/FiO₂ and SaO₂ values in the treatment group were higher than those in the control group, and the PaCO₂ values in the treatment group were lower than those in the control group, the differences were statistically significant (P<0.05). After treatment, the measured values of Cvin, Cvex, lung transverse diameter, LAA%-950insp, LAA%-856exp in the treatment group were lower than those in the control group (P<0.05). After treatment, the CAT score and mMRC score of the treatment group were lower than those of the control group (P<0.05). After one week of treatment, the effective rate of the treatment group was higher than that of the control group (P<0.05). The effect of transnasal HFNC on COPD patients complicated with respiratory failure is significant. CT lung scan can effectively observe the changes of lung function before and after transnasal HFNC treatment, which is of great significance for evaluating the clinical treatment effect.

Key words: chronic obstructive pulmonary disease, respiratory failure, non-invasive ventilation, nasal high-flow humidified oxygen inhalation, CT

梁金排, 赵红玲, 张冰, 刘淑红, 肖翠君, 闫锡新, 柴书坤, 刘莉. 老年COPD合并呼吸衰竭患者HFNC治疗效果及CT参数变化分析[J]. 影像科学与光化学, 2022, 40(5): 1195-1199.

LIANG Jinpai, ZHAO Hongling, ZHANG Bing, LIU Shuhong, XIAO Cuijun, YAN Xixin, CHAI Shukun, LIU Li. Analysis of HFNC Therapeutic Effect and CT Parameters Changes in Elderly COPD Patients Complicated with Respiratory Failure[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1195-1199.

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老年COPD合并呼吸衰竭患者HFNC治疗效果及CT参数变化分析

Analysis of HFNC Therapeutic Effect and CT Parameters Changes in Elderly COPD Patients Complicated with Respiratory Failure

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