ABSTRACT
Objective To observe the clinical efficacy of high-flow nasal cannula oxygen therapy(HFNC)and non-invasive mechanical ventilation in patients with typeⅡrespiratory failure during acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 84 patients with AECOPD combined with typeⅡrespiratory failure admitted to the department of internal medicine of Beijing Sijiqing Hospital from September 2019 to December 2021 were selected as the study objects.The patients were randomly divided into observation group and control group,with 42 cases in each group.Both groups were given conventional treatment,the observation group was given HFNC,and the control group was given non-invasive mechanical ventilation.The difference of clinical efficacy between the two groups was compared,and the changes of heart rate(HR),respiratory rate(RR),arterial blood gas analysis index,lung function before and 7 days after treatment,complications and tracheal intubation rate,mortality were observed in the two groups.Results The total effective rate of the observation group was higher than that of the control group[88.10%(37/42)vs.69.05%(29/42),P＜0.05].Before treatment,HR,RR,arterial blood gas analysis indexes[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation(SaO2),pH value],pulmonary function indexes[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC]of the two groups were no statistically significant.After treatment,HR,RR and PaCO2 were significantly lower than before treatment,while PaO2,SaO2,pH,FEV1,FVC and FEV1/FVC were significantly higher than before treatment.After treatment,HR,RR and PaCO2 in the observation group were significantly lower than those in the control group[HR(bpm):90.14±5.66 vs.93.57±4.77,RR(times/min):21.90±4.88 vs.22.45±4.31,PaCO2(mmHg,1 mmHg≈0.133 kPa):60.02±5.93 vs.62.83±6.29],PaO2,SaO2,pH,FEV1,FVC,FEV1/FVC were significantly higher than the control group[PaO2(mmHg):80.70±7.81 vs.76.21±8.23,SaO2:0.94±0.04 vs.0.92±0.04,pH value:7.36±0.05 vs.7.32±0.06,FEV1(L):1.73±0.41 vs.1.53±0.35,FVC(L):2.80±0.48 vs.2.57±0.43,FEV1/FVC:(61.98±5.67)%vs.(59.14±5.34)%,all P＜0.05].The incidence of complications such as of dry throat[4.8%(2/42)vs.19.0%(8/42)],facial compression injury[0%(0/42)vs.14.3%(6/42)],abdominal distension[9.5%(4/42)vs.26.2%(11/42)]in the observation group were significantly lower than those in the control group(all P＜0.05).There was no significant difference in the rate of tracheal intubation and mortality between the observation group and the control group[11.90%(5/42)vs.26.19%(11/42)and 4.76%(2/42)vs.7.14%(3/42),both P＞0.05].Conclusion HFNC is effective in treating AECOPD patients with typeⅡrespiratory failure,with fewer complications and high safety.