【摘要】 目的 探究无创正压通气与经鼻高流量氧疗对慢性阻塞性肺疾病急性加重期（AECOPD）患者疗效及预后的影响比较。方法 回顾性分析2022年4月至2023年12月安徽省阜阳市第二人民医院收治的105例AECOPD患者，根据治疗方案不同分为经鼻高流量氧疗组（HFNC组，43例）与无创正压通气组（NIPPV组，44例）。对比2组患者临床情况、治疗前后生理指标、血气相关指标、免疫指标、生化指标及并发症及预后。结果 HFNC组72 h内气道护理次数明显低于NIPPV组（P<0.05）,72 h内耐受呼吸支持时间及机械通气时间明显高于NIPPV组（P<0.05）;HFNC组痰液粘稠度明显改善（P<0.05）;2组住院时间差异无统计学意义（P>0.05）；治疗72 h后，2组心率（HR）、呼吸频率（RESP）明显下降（P<0.05）,SpO₂明显上升（P<0.05），血气pH、氧分压（PaO²）明显上升（P<0.05），二氧化碳分压（PaCO₂）明显下降（P<0.05），但2组间差异均无统计学意义（P>0.05）；治疗72 h后，2组CD3⁺CD4⁺、CD3⁺CD8⁺、CD4⁺/CD8⁺均上升（P<0.05），血清淀粉样蛋白A（SAA）、中性粒细胞均明显下降（P<0.05）,HFNC组治疗72 h后各指标与NIPPV组比差异有统计学意义（P<0.05）;HFNC组并发症发生率明显低于NIPPV组（P<0.05）,2组半年内再入院率差异无统计学意义（P>0.05）。结论 相较无创正压通气，经鼻高流量氧疗更容易被患者接受，该氧疗技术可有效提高患者免疫水平，减少不良事件发生率，值得应用。更多还原

【Abstract】 Objective To compare and explore the influence of non-invasive positive pressure ventilation （NIPPV） and high-flow nasal cannula （HFNC） oxygen therapy on the efficacy and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods A retrospective analysis was performed on 105 patients with AECOPD in the hospital from April 2022 to Decemberl 2023.The patients were divided into HFNC group （n=43,HFNC oxygen therapy）and NIPPV group （n=44,NIPPV） by different treatment regimens.The clinical conditions,physiological indexes,blood gas related indexes,immune indexes and biochemical indexes before and after treatment,complications and prognosis were compared between both groups.Results The frequency of airway nursing within 72 hours in HFNC group was significantly less than that in NIPPV group （P<0.05）,and the tolerable respiratory support time within 72 hours and mechanical ventilation time were significantly longer （P<0.05）.The sputum viscosity in HFNC group was significantly improved （P<0.05）,but there was no significant difference in hospital stay between groups （P>0.05）.After 72 hours of treatment,the heart rate （HR） and respiratory rate （RESP） in both groups were significantly reduced （P<0.05） while the SpO₂ was significantly enhanced （P<0.05）,and the blood gas pH and partial pressure of oxygen （PaO₂） were significantly increased （P<0.05） while the partial pressure of carbon dioxide （PaCO₂） was significantly decreased （P<0.05）,but there were no statistical differences between the two groups （P>0.05）.After 72 hours of treatment,CD3⁺CD4⁺,CD3⁺CD8⁺and CD4⁺/CD8⁺were risen in both groups （P<0.05）,and serum amyloid A （SAA） and neutrophil-to-lymphocyte ratio （NLR） were significantly decreased （P<0.05）,and there were significant differences between HFNC group and NIPPV group after72 hours of treatment （P<0.05）.The incidence rates of complications in HFNC group were significantly lower than those in NIPPV group （P<0.05）,but there was no obvious difference in the readmission rate within half a year between groups （P>0.05）.Conclusion Compared with non-invasive positive pressure ventilation,high-flow nasal cannula oxygen therapy is more easily accepted by patients.This oxygen therapy technique can effectively enhance the immune level and reduce the incidence rates of adverse events.更多还原