MSCT评估AECOPD并发轻度Ⅱ型呼吸衰竭患者HFNC疗效的研究

doi:10.7517/issn.1674-0475.221008

摘要/Abstract

摘要： 本研究探讨了多层螺旋CT （MSCT）评估经鼻高流量氧疗（HFNC）治疗慢性阻塞性肺疾病急性加重期（AECOPD）并发轻型Ⅱ型呼吸衰竭患者效果的价值。选取AECOPD合并轻度Ⅱ型呼吸衰竭患者200例，按随机数字表法随机分为对照组和观察组，每组100例。对照组采用基础治疗+常规吸氧，治疗组采用基础治疗+HFNC治疗。对比两组患者治疗前后的血气参数指标：动脉血氧分压（PaO₂）、经皮血氧饱和度（SaO₂）、动脉血二氧化碳分压（PaCO₂）、pH、氧合指数（OI）。采用MSCT测定两组患者的单肺、全肺肺容积（L）、肺气肿容积（E）、肺动脉内径、主动脉内径。采用彩色多普勒超声检测右心功能指标[右室舒张末期内径（EDRV）、右室前壁（RVAW）及右室射血分数（EFRV）]变化。结果显示，治疗后，治疗组PaO₂、SaO₂、OI测定值大于对照组，PaCO₂测定值低于对照组（P<0.05）；治疗后，治疗组患者的全肺E/L、右肺E/L低于对照组（P<0.05）；治疗后，治疗组患者的EFRV、RVAW测定值大于对照组（P<0.05）。研究发现，AECOPD并发轻型Ⅱ型呼吸衰竭患者采用HFNC治疗具有更好的效果，采用MSCT可观察患者治疗前后的肺气肿病情及肺动脉高压改善程度。

关键词: 多层螺旋CT, 经鼻高流量氧疗, 慢性阻塞性肺疾病急性加重期, Ⅱ型呼吸衰竭

Abstract: This study investigated the value of multi-slice spiral CT (MSCT) in evaluating the effect of high-flow nasal cannula oxygen therapy (HFNC) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by mild type Ⅱ respiratory failure. Selected 200 patients with AECOPD complicated with mild type Ⅱ respiratory failure and randomly divided them into control group and observation group according to the random number table method, with 100 cases in each group. The control group was treated with basic treatment + conventional oxygen inhalation, while the treatment group was treated with basic treatment +HFNC. Blood gas parameters[arterial partial pressure of oxygen (PaO₂), percutaneous oxygen saturation (SaO₂), arterial partial pressure of carbon dioxide (PaCO₂), pH value, oxygen and index (OI)] were compared between the two groups before and after treatment. MSCT was used to measure the single and whole lung volume (L), emphysema volume (E), pulmonary artery diameter and aortic diameter of the two groups. Color doppler ultrasound was used to detect the changes of right ventricular function indexes[right ventricular end diastolic diameter (RVDD), right ventricular anterior wall (RVAW) and right ventricular ejection fraction (RVEF)]. The results showed that after treatment, the measured values of PaO₂, SaO₂ and OI in the treatment group were higher than those in the control group, while the measured values of PaCO₂ were lower than those in the control group (P<0.05). After treatment the whole lung volume E/L, right lung E/L in the treatment group were lower than those in the control group. After treatment, the measured values of RVEF and RVAW in the treatment group were higher than those in the control group (P<0.05). The study found that patients with AECOPD complicated by mild type Ⅱ respiratory failure treated with HFNC had better effect, and MSCT could be used to observe the improvement of emphysema and pulmonary hypertension before and after treatment.

Key words: multi-slice spiral CT, nasal high-flow oxygen therapy, cute exacerbation of chronic obstructive pulmonary disease, type Ⅱ respiratory failure

赵红玲, 梁金排, 肖翠君. MSCT评估AECOPD并发轻度Ⅱ型呼吸衰竭患者HFNC疗效的研究[J]. 影像科学与光化学, 2023, 41(1): 114-118.

ZHAO Hongling, LIANG Jinpai, XIAO Cuijun. MSCT to Evaluate the Efficacy of HFNC in Patients with AECOPD Complicated with Mild Type Ⅱ Respiratory Failure[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 114-118.

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