经鼻高流量湿化仪氧疗联合支气管镜肺泡灌洗在老年吸入性肺炎合并低氧血症患者中的临床观察

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Abstract Objective To investigate the clinical observation of transnasal high-flow humidifier oxygen therapy combined with bronchoscopy alveolar lavage (BAL) in elderly patients with aspiration pneumonia and hypoxemia. Methods The clinical data of 56 elderly patients with aspiration pneumonia and hypoxemia who were admitted to Taishan Hospital of Traditional Chinese Medicine from March 2019 to April 2020 were retrospectively analyzed. The patients who were treated with transnasal high-flow humidifier oxygen therapy combined with BAL treatment were returned for the treatment group (28 cases), patients who were routinely given basic treatments such as anti-infection, spasmolysis and asthma, cough and phlegm, oxygen inhalation, nutritional support, correction of acid-base imbalance, and maintenance of water and electrolyte disorders were classified as the control group (28 cases). The clinical efficacy and blood gas indexes, tracheal intubation rate, ICU occupancy rate, and acute physiology and chronic health score Ⅱ (APACHEⅡ)before and after 14 days of treatment were compared between the two groups. Results Compared with the control group,the total clinical effective rate of the treatment group was higher, and the difference was statistically significant (P<0.05). There were no significant differences in blood oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) between the two groups before treatment (P＞0.05); after 14 days of treatment, the two groups′ SaO2 and PaO2 indicators increased, PaCO2 index decreased, and the treatment group changed greatly, the differences were statistically significant (P<0.05). The tracheal intubation rate and ICU occupancy rate in the treatment group were lower than those in the control group, and the differences were statistically significant(P<0.05). Compared with the APACHE Ⅱscores before treatment between the two groups, the difference was not statistically significant (P＞0.05). After 14 days of treatment, the APACHE Ⅱscores of the two groups decreased, and the scores of the treatment group were lower, the differences were statistically significant (P<0.05). Conclusion Elderly patients with aspiration pneumonia combined with hypoxemia have a significant effect of transnasal high-flow humidifier oxygen therapy combined with BAL treatment, which can improve clinical efficacy, improve blood gas indicators, reduce tracheal intubation rate and ICU occupancy rate, and reduce APACHE Ⅱscore. It is worthy of clinical promotion.

Key words： Aspiration pneumonia Hypoxemia Oxygen therapy with nasal high-flow humidifier Bronchoscopy alveolar lavage Blood gas index

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	YI Xiao-li
	LI Yang-yang
	YANG Jun-wei

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YI Xiao-li,LI Yang-yang,YANG Jun-wei. Cinical observation of oxygen therapy combined with bronchoscope alveolar lavage by nasal high flow humidifier in elderly patients with aspiration pneumonia and hypoxemia[J]. 中国当代医药, 2021, 28(3): 48-51.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I3/48

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