对比三种供氧方式对慢性阻塞性肺疾病合并呼吸衰竭氧浓度的影响

目的对比无创呼吸机的三种供氧方式对慢性阻塞性肺疾病(慢性阻塞性肺疾病)合并呼吸衰竭患者吸氧浓度的影响。方法选取2014年9月—2020年9月在盐城市第三人民医院住院的慢性阻塞性肺疾病合并有Ⅱ型呼吸衰竭的患者30例,同时选取健康成年人30例。分别给两组受试者无创呼吸机辅助通气,将氧气导管分别接在面罩的通气口上,面罩内单鼻塞和双鼻导管吸氧,给不同给氧流量,分别为3 L/min、5 L/min,分别检测在三种不同吸氧方式和吸氧浓度下的PcO₂和PcCO₂,生命体征变化。结果慢性阻塞性肺疾病患者在使用面罩呼吸机后,PcO₂在由高到低分别为面罩内双鼻导管给氧时,面罩内单鼻塞给氧时,面罩通气口给氧时,与呼吸空气时比较(P<0.05),PcCO₂变化,差异有统计学意义(P<0.05)。对比三种无创呼吸机面罩吸氧方式和呼吸空气状态时,心率、呼吸频率有所改善(P<0.05),血压变化不明显,差异无统计学意义(P>0.05)。结论对于慢性阻塞性肺疾病合并有呼吸衰竭使用无创呼吸机的患者使用面罩内双孔鼻导管吸氧较面罩内单鼻塞吸氧和面罩通气口给氧效果更佳。

Compare the Effects of Three Oxygen Supply Modes on Oxygen Concentration in Chronic Obstructive Pulmonary Disease Complicated With Respiratory Failure

Objective To compare the effects of three oxygen supply modes of noninvasive ventilator on oxygen concentration in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods From September 2014 to September 2020,30 COPD patients with typeⅡrespiratory failure and 30 healthy adults were selected.The patients in the two groups were given noninvasive ventilator assisted ventilation.The oxygen tubes were connected to the ventilation port of the mask,and the oxygen was inhaled by one nasal plug and two nasal tubes in the mask.The oxygen flow rates were 3 L/min and 5 L/min respectively.The changes of PcO₂ and PcCO₂ and vital signs were detected under three different oxygen inhalation methods and oxygen concentrations.Results After using the mask ventilator,the PcO₂ of COPD patients from high to low were given oxygen by the double nasal catheter in the mask,by the single nasal obstruction in the mask,by the mask ventilation port.These modes of oxygen inhalation were statistical significance to those of breathing air(P<0.05).However,the changes of PcCO₂ were not statistical significance(P<0.05).Comparison of three kinds of noninvasive ventilator mask oxygen inhalation mode and breathing air state,the heart rate and respiratory rate were improved(P<0.05),but the blood pressure did not change significantly(P>0.05).Conclusion For COPD patients with respiratory failure using noninvasive ventilator,the effect of oxygen inhalation with double orifice nasal catheter in mask is better than that with single nasal plug and mask vent.