【摘要】 目的:分析HFNC（高流量氧治疗）联合呼吸兴奋剂治疗慢性阻塞性肺病（简称慢阻肺）急性加重（Acute exacerbation of chronic obstructive pulmonary disease,AECOPD）合并Ⅱ型呼吸衰竭的临床效果。方法:选取2018年5月至2019年5月收治的150例慢阻肺急性加重合并Ⅱ型呼吸衰竭患者,随机分为呼吸兴奋剂组、联合组、HFNC组;呼吸兴奋剂组患者进行呼吸兴奋剂治疗,联合组患者进行HFNC联合呼吸兴奋剂治疗,HFNC组仅进行HFNC治疗;比较3组患者的临床疗效,治疗前后患者的心率、呼吸频率、动脉血气、肺功能。结果:联合组患者的临床疗效总有效率为90.00%,较呼吸兴奋剂组、HFNC组高（P<0.05）;治疗前3组患者的心率、呼吸频率、PaO₂、PaCO₂、pH值、FEV1、FEV1/FVC相比,差异无统计学意义（P>0.05）;治疗后（24 h、72 h、7 d）3组患者的心率、呼吸频率、PaCO₂均降低（P<0.05）,PaO₂、PH、FEV1、FEV1/FVC均上升（P<0.05）,且治疗后（24 h、72 h、7 d）联合组患者心率、呼吸频率下降更多（P<0.05）,PaO₂、FEV1、FEV1/FVC上升更多,PaCO₂降低更多（P<0.05）。结论:HFNC联合呼吸兴奋剂治疗慢阻肺急性加重合并Ⅱ型呼吸衰竭可提高临床疗效,降低患者心率、呼吸频率,改善肺功能,促进疾病康复,建议在临床上推广。更多还原

【Abstract】 Objective:To investigate the clinical effects of HFNC（high-flow oxygen therapy） combined with respiratory stimulant in the treatment of AECOPD with type Ⅱ respiratory failure.Methods: 150 patients with AECOPD and type Ⅱ respiratory failure admitted from May 2018 to May 2019 were selected and divided into groups A, B and C randomly. Group A was given respiratory stimulant treatment, group B was given HFNC combined with respiratory stimulant, and group C was given only HFNC treatment. Results: The total effective rate of clinical efficacy in group B was 90.00 %, which was significantly higher than that in group A and C（P<0.0167）. There was no significant difference in heart rate, respiratory rate, PaO₂, PaCO₂, PH value, FEV1 and FEV1/FVC between the three groups before treatment（P>0.05）, after treatment（24 h, 72 h, 7 d）, the heart rate, respiratory rate and PaCO₂ were decreased, PaO₂, PH, FEV₁, FEV₁/FVC were all increased after treatment（24 h, 72 h, 7 d）. The heart rate and respiratory rate of group B decreased more significantly（P<0.05）, PaO₂, FEV₁, FEV₁/FVC increased more significantly, and PaCO₂ decreased more significantly（P<0.05）.Conclusion: HFNC combined with respiratory stimulant treatment of AECOPD combined with type Ⅱ respiratory failure can significantly improve clinical efficacy, reduce heart rate, reduce respiratory rate, improve oxygenation and lung function, and promote disease recovery. It is recommended to be clinically popularized.更多还原