经鼻高流量氧疗和无创通气在慢性阻塞性肺疾病合并呼吸衰竭中的比较

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1、授予单位代码10089学号或申请号16106中国图书分类号R563HebeiMedicalUniversity硕士学位论文学术学位经鼻高流量氧疗和无创通气在慢性阻塞性肺疾病合并呼吸衰竭中的比较研究生：刘晶导师：崔朝勃教授专业：内科学二级学院：衡水市哈励逊国际和平医院2018年3月目录中文摘要················································································1英文摘要·································································

2、···············3英文缩写················································································6研究论文经鼻高流量氧疗和无创通气在慢性阻塞性肺疾病合并呼吸衰竭中的比较前言················································································7材料与方法······································································10

3、结果···············································································13附图···············································································15附表···············································································16讨论·············································

4、··································19结论···············································································22参考文献·········································································22综述经鼻高流量吸氧的临床应用研究进展·····································36致谢·······································

5、··············································50个人简历···············································································51经鼻高流量氧疗和无创通气在慢性阻塞性肺疾病合并呼吸衰竭中的比较摘要目的：慢性阻塞性肺疾病急性加重（AcuteExacerbationofChronicObstructivePulmonaryDisease，AECOPD）是临床上常见的一种疾病类型，对于COPD的治疗，临床上除了常规的基础治疗外，还应积极给予辅助通气改善患者的

6、氧合、减轻二氧化碳潴留，纠正呼吸衰竭症状。本研究拟通过对比经鼻高流量氧疗(highflownasalcannula，HFNC)与无创正压通气(non-invasivepositivepressureventilation，NIPPV)在AECOPD合并II型呼吸衰竭患者中的应用效果，分析其对AECOPD合并II型呼吸衰竭的临床应用价值，旨在为临床上AECOPD合并II型呼吸衰竭的治疗提供可靠的理论依据及数据支持。方法：根据2015年版《慢性阻塞性肺病防治倡议》(GOLD指南)要求，选取2016年12月至2018年1月期间来哈励逊国际和平医院呼吸科住院治疗的AECOPD合并II型呼吸衰竭

7、的患者共268名作为研究对象，符合入选标准及排除标准的患者共105名，经逐一筛选最终共有75名患者纳入本研究，均签署知情同意书，记录其性别、年龄等一般情况。采用随机数字表法将分析对象划分为经鼻高流量组（HFNC组，38例）和无创通气组（NIPPV组，37例）。HFNC组在常规治疗的基础上给予经鼻高流量治疗，NIPPV组患者在常规治疗的基础上给予无创正压通气治疗，最后通过比较两组患者治疗前、治疗后2小时、治疗后6小时、治疗后12小时及治疗后24小