| 龙亮,黄文婷,龙发,等.加温加湿经鼻高流量氧疗对难治性哮喘病人支气管热成形术后的应用及机制研究[J].安徽医药,2024,28(10):1989-1993. |
| 加温加湿经鼻高流量氧疗对难治性哮喘病人支气管热成形术后的应用及机制研究 |
| Application and mechanism of nasal high flow oxygen therapy with heating and humidification after bronchoplasty in patients with refractory asthma |
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| DOI：10.3969/j.issn.1009-6469.2024.10.017 |
| 中文关键词: 氧吸入疗法 氧流量 哮喘 支气管热成形术 作用机制 |
| 英文关键词: Oxygen inhalation therapy Oxygen flow rate Asthma Bronchial thermoplasty Mechanism of action |
| 基金项目:深圳市光明区软科学研究项目( 2021R01104) |
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| 中文摘要: |
| 目的探讨加温加湿经鼻高流量氧疗对难治性哮喘病人支气管热成形术(BT)后的应用及机制。方法选择 2021年 1月至 2022年 10月在中国科学院大学深圳医院(光明)拟行 BT的哮喘病人 118例进行研究。采用随机数字表法将病人分为两组，每组各 59例。两组均行 BT治疗，术后对照组病人给予常规鼻导管吸氧，观察组则行经鼻高流量氧疗(HFNC)。比较两组病人临床疗效、痰液黏稠度、舒适度、生活质量、炎症因子、呼出气一氧化氮(FeNO)、血气分析指标及疗程结束后 3周内并发症发生情况。结果观察组病人显效率、总有效率分别为 64.41%、96.61%，高于对照组的 38.98%、86.44%(P<0.05)。治疗后两组 Ⅲ度黏痰占比、 ACQ得分、 TNF-α、FeNO及二氧化碳分压均低于治疗前，但观察组低于对照组；治疗后两组 CQC得分、 AQLQ得分、 ACT得分、 IL-10、氧分压均高于治疗前，但观察组高于对照组( P<0.05)。治疗后两组均高于治疗前，但观察组高于对照组( P<0.05)。两组治疗前后 pH均差异无统计学意义( P>0.05)。对照组共出现 16例( 27.12%)并发症，高于观察组的 6例( 10.16%)并发症( P<0.05)。结论难治性哮喘病人 BT后 HFNC较常规鼻导管吸氧可有效提高临床疗效，提高病人舒适度与生活质量，降低痰液黏稠度；其机制可能与 HFNC可改善炎症水平和血气分析指标、降低 FeNO水平有关。 |
| 英文摘要: |
| Objective To investigate the application and mechanism of warming and humidifying nasal high flow oxygen therapy inpatients with refractory asthma after bronchoplasty.Methods From January 2021 to October 2022, 118 asthmatic patients who werescheduled to undergo bronchoplasty in Shenzhen Hospital, University of Chinese Academy of Sciences (Guangdong) were studied. Thepatients were randomly divided into two groups with 59 cases in each group. The patients in the control group were given routine nasalcatheter oxygen inhalation, and the patients in the observation group were given intranasal high flow oxygen therapy (HFNC). The clinical efficacy, sputum viscosity, comfort, quality of life, inflammatory factors, exhaled nitric oxide (FeNO), blood gas analysis indexes andcomplications within 3 weeks after operation were compared between the two groups.Results The apparent and total effective rates ofpatients in the observation group were 64.41% and 96.61%, respectively, which were higher than 38.98% and 86.44% in the controlgroup (P<0.05). After treatment, the proportion of third-degree mucus, ACQ score, TNF of the two groups-α, FeNO and carbon dioxidepartial pressure were lower than those before treatment, but the observation group was lower than the control group; After treatment, theCQC score, AQLQ score, ACT score, IL-10 and oxygen partial pressure of the two groups were higher than those before treatment, butthe observation group was higher than the control group (P<0.05). After treatment, both groups were higher than before treatment, but the observation group was higher than the control group (P<0.05). There was no significant difference in pH between the two groups before and after treatment (P>0.05). There were 16 cases (27.12%) of complications in the control group, which was higher than 6 cases(10.16%) in the observation group (P<0.05).Conclusions Compared with conventional nasal catheter oxygen inhalation after bronchial thermoplasty in patients with refractory asthma, HFNC can effectively improve the clinical efficacy, improve patients' comfort andquality of life, and reduce sputum viscosity. The mechanism may be related to the fact that HFNC can improve the level of inflammationand blood gas analysis indicators, and it can reduce the level of FeNO. |
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