陈永华 庞世梅

【摘要】 目的：探讨经鼻高流量吸氧（HFNC）对慢性阻塞性肺疾病急性加重期（AECOPD）合并呼吸衰竭患者炎症因子与呼吸功能的影响。方法：选择笔者所在医院接受治疗的AECOPD合并呼吸衰竭患者86例进行回顾性分析。根据治疗方式不同将其分为两组，每组43例。对照组行无创通气治疗，观察组行HFNC治疗。比较两组患者炎症因子水平及呼吸功能。结果：治疗后两组患者IL-6、IL-8及TNF-α水平均明显降低，且观察组降低幅度大于对照组，差异有统计学意义（P<0.05）。治疗后两组患者FEV1、FVC及FEV1/FVC水平均明显升高，且观察组升高幅度大于对照组，差异有统计学意义（P<0.05）。结论：HFNC可明显缓解AECOPD合并呼吸衰竭患者炎症反应，改善呼吸功能。

【关键词】 经鼻高流量吸氧 慢性阻塞性肺疾病急性加重期 呼吸衰竭 炎症因子 呼吸功能

doi：10.14033/j.cnki.cfmr.2019.28.070 文献标识码 B 文章编号 1674-6805（2019）28-0-02

Effects of High-flow Nasal Cannula Oxygen Therapy on Inflammatory Factors and Respiratory Function in Patients with Respiratory Failure Complicated with AECOPD/CHEN Yonghua， PANG Shimei. //Chinese and Foreign Medical Research， 2019， 17 （28）： -165

[Abstract] Objective： To investigate the effect of High-flow nasal cannula oxygen therapy （HFNC） on inflammatory factors and respiratory function in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure. Method： A total of 86 cases of AECOPD patients complicated with respiratory failure treated in our hospital were retrospectively analyzed. According to the different treatment methods， the patients were divided into two groups， with 43 cases in each group. The control group received non-invasive ventilation treatment， while the observation group received HFNC treatment. The inflammatory factors and respiratory function were compared between the two groups. Result： After treatment， the levels of IL-6， IL-8 and TNF-α in the two groups were significantly decreased， and the decrease in the observation group was greater than that in the control group， the differences were statistically significant （P<0.05）. After treatment， the levels of FEV1， FVC and FEV1/FVC were significantly increased in both groups， and the increase in the observation group was greater than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： HFNC can significantly relieve the inflammatory reaction and improve respiratory function in patients with AECOPD complicated with respiratory failure.

[Key words] High-flow nasal cannula oxygen therapy AECOPD Respiratory failure Inflammatory factors Respiratory function

First-authors address： The Second Peoples Hospital of Macheng， Macheng 438300， China

慢性阻塞性肺疾病（COPD）作為一种严重危害人类健康的常见病，病死率较高[1]。大部分慢性阻塞性肺疾病急性加重期（AECOPD）患者出现意识障碍，生命体征不稳定时需建立人工气道实施有创机械通气[2-3]。经鼻高流量吸氧（HFNC）可提供浓度恒定且高流量氧气，可为患者提供充足的氧气而改善氧合[4]。目前对于HFNC对AECOPD患者的应用研究较少，本研究旨在通过探讨HFNC对AECOPD合并呼吸衰竭患者炎症因子与呼吸功能的影响，以期为临床提供参考，现报道如下。

1 资料与方法

1.1 一般资料

选择笔者所在医院2017年6月-2018年12月接受治疗的AECOPD合并呼吸衰竭患者86例进行回顾性分析。纳入标准：（1）符合《慢性阻塞性肺疾病诊治指南（2013年修订版）》中AECOPD合并呼吸衰竭的相关诊断标准[5];（2）患者意识清晰可与医护人员进行正常交流并配合治疗。排除标准：（1）合并恶性肿瘤者;（2）免疫系统疾病者;（3）支气管哮喘、支气管扩张等其他肺部疾病患者。……