The Clinical Observation And Study Of High Flow Nasal Cannula Oxygen Therapy In Patients With Bronchiectasis

Objective:To compare the clinical application effect of two kinds of oxygen therapy on patients with bronchiectasis by high flow nasal cannula oxygen therapy and conventional oxygen therapy,and to further explore the clinical advantages of high flow nasal cannula oxygen therapy in patients with bronchiectasis,so as to provide clinical evidence-based basis for high flow nasal cannula oxygen therapy to better treat patients with bronchiectasis.Methods:A total of 60 patients with bronchiectasis admitted to Chengde Central Hospital of Hebei Province from October 2019 to December 2020 were selected as the research objects and randomly divided into high flow nasal cannula oxygen therapy group（group A）and conventional oxygen therapy group（group B）,30 cases in each group.Both groups were given comprehensive treatment such as anti-infection,relieving airway spasm,cooling and symptomatic treatment.On the basis of the above treatment,group A was given high flow nasal cannula oxygen therapy,and group B was given conventional oxygen inhalation（nasal catheter）.General information（gender,age,course of disease,BMI）,blood gas analysis of radial artery blood before and 2h after treatment and 24h after treatment（arterial partial pressure of oxygen/PaO₂,arterial partial pressure of carbon dioxide/PaCO₂,arterial oxygen saturation/SaO₂）,general vital signs（heart rate,respiratory rate）,Borg’s score before and 72 hours after treatment were collected.SPSS 25.0 software was used to analyze the data.The general information,arterial blood gas analysis index,general vital signs and Borg’s score of the two groups were compared.The difference was statistically significant（P<0.05）.Results:1 Comparison of general data between the two groupsThere was no statistically significant difference in gender,age,course of disease,BMI and other general information between group A and group B（P>0.05）.There was no statistically significant difference in PaO₂,SaO₂,PaCO₂,heart rate,respiratory rate and Borg’s score between group A and group B before treatment（P=0.727,P=0.715,P=0.244,P=0.177,P=0.110,P=0.575）.2 The Comparison of arterial blood gas analysis indexes between two groups:2.1 Comparison of arterial partial pressure of oxygen:2.1.1 Comparison of PaO₂within group A:Compared with group A before treatment,the PaO₂in group A respectively increased at 2h and 24h after treatment,and the differences were statistically significant（P<0.001,P<0.001）.Compared with 2 hours after treatment in group A,the PaO₂in group A increased at 24 hours after treatment,the difference was statistically significant（P<0.001）.2.1.2 Comparison of PaO₂within group B:Compared with group B before treatment,the PaO₂in group B respectively increased at 2h and 24h after treatment,the differences were statistically significant（P<0.001,P<0.001）.Compared with 2 hours after treatment in group B,the PaO₂in group B increased at 24 hours after treatment,the difference was statistically significant（P<0.001）.2.1.3 Comparison of PaO₂between group A and group B:Compared with PaO₂at 2 hours after treatment of group B,the PaO₂in group A was higher at 2 hours after treatment,and the difference was statistically significant（P<0.001）.There was no statistically significant difference in PaO₂between group A and group B at 24 hours after treatment（P=0.297）.2.2 Comparison of SaO₂:2.2.1 Comparison of SaO₂within group A:Compared with group A before treatment,the SaO₂in group A respectively increased at 2h and 24h after treatment,and the differences were statistically significant（P<0.001,P<0.001）.Compared with 2 hours after treatment in group A,the SaO₂in group A increased at 24 hours after treatment,and the difference was statistically significant（P<0.001）.2.2.2 Comparison of SaO₂within group B:Compared with group B before treatment,the SaO₂in group B respectively increased at 2h and 24h after treatment,and the differences were statistically significant（P=0.001,P<0.001）.Compared with 2 hours after treatment in group B,the SaO₂in group B increased 24 hours after treatment,the difference was statistically significant（P<0.001）.2.2.3 Comparison of SaO₂between group A and group B:Compared with SaO₂at 2 hours after treatment of group B,the SaO₂of group A was higher at 2 hours after treatment,and the difference was statistically significant（P<0.001）.There was no statistically significant difference in SaO₂24 hours after treatment between group A and group B（P=0.057）.2.3 Comparison of arterial partial pressure of carbon dioxide:2.3.1 Comparison of PaCO₂within group A:Compared with group A before treatment,the PaCO₂in group A respectively decreased at 2h and 24h after treatment,and the differences were statistically significant（P<0.001,P<0.001）.Compared with 2 hours after treatment in group A,the PaCO₂in group A decreased at 24 hours after treatment,the difference was statistically significant（P<0.001）.2.3.2 Comparison of PaCO₂within group B:Compared with group B before treatment,the PaCO₂in group B respectively decreased at 2h and 24h after treatment,and the differences were statistically significant（P=0.048,P<0.001）.However,there was no statistically significant difference in PaCO₂between 2h and 24h after treatment in group B（P=0.126）.2.3.3 Comparison of PaCO₂between group A and group B:There was no statistically significant difference in PaCO₂2 hours after treatment between group A and group B（P=0.874）.Compared with PaCO₂of 24 hours after treatment in group B,the PaCO₂24 hours after treatment in group A was lower which the different was statistically significant（P<0.001）.3 Comparison of general vital signs between group A and group B:3.1 Comparison of heart rate:3.1.1 Comparison of heart rate within group A:Compared with group A before treatment,the heart rate of group A respectively decreased at 2 hours after treatment and 24 hours of treatment,the differences were statistically significant（P<0.001,P<0.001）.Compared with group A 2 hours after treatment,the heart rate of group A decreased 24hours after treatment,the difference was statistically significant（P<0.001）.3.1.2 Comparison of heart rate within group B:Compared with group B before treatment,the heart rate of group B respectively decreased at 2 hours after treatment and 24 hours of treatment,the differences were statistically significant（P<0.001,P<0.001）.Compared with group B 2 hours after treatment,the heart rate of group B decreased at24 hours after treatment,the difference was statistically significant（P<0.001）.3.1.3 Comparison of heart rate between group A and group B:Compared with 2 hours after treatment in group B,the heart rate in group A was lower which the difference was statistically significant（P=0.006）.Compared with group B at 24 hours after treatment,the heart rate of group A at 24 hours after treatment was lower,the difference was statistically significant（P<0.001）.3.2 Comparison of respiratory rate:3.2.1 Comparison of respiratory rate within group A:Compared with group A before treatment,the respiratory rate of group A respectively decreased at 2 hours and 24 hours after treatment,and the differences were statistically significant（P<0.001,P<0.001）.Compared with2 hours after treatment in group A,the respiratory rate of group A decreased at 24 hours after treatment,the difference was statistically significant（P<0.001）.3.2.2 Comparison of respiratory rate within group B:Compared with group B before treatment,the respiratory rate of group B respectively decreased at 2 hours and 24 hours after treatment,and the differences were statistically significant（P<0.001,P<0.001）.Compared with group B at 2 hours after treatment,the respiratory rate of group B decreased at 24 hours after treatment,the difference was statistically significant（P<0.001）.3.2.3 Comparison of respiratory rate between group A and group B:There was no statistically significant difference in respiratory rate at 2hours after treatment between group A and group B（P=0.145）.Compared with group B at 24 hours after treatment,the respiratory rate of group A was lower,the difference was statistically significant（P=0.001）.4 Comparison of Borg’s score between group A and group B:4.1 Comparison of Borg’s score within group A:Compared with group A before treatment,Borg’s score of group A decreased at 72 hours after treatment,and the difference was statistically significant（P<0.001）.4.2 Comparison of Borg’s score within group B:Compared with group B before treatment,Borg’s score of group B decreased at 72 hours after treatment,the difference was statistically significant（P<0.001）.4.3 Comparison of Borg’s score between group A and group B:The Borg’s score of group A was lower than that of group B at 72 hours after treatment（P<0.001）.Conclusion:1.High flow nasal cannula oxygen therapy can better improve the oxygenation of patients with bronchiectasis and reduce arterial partial pressure of carbon dioxide.2.High flow nasal cannula oxygen therapy can more effectively improve the respiratory distress of patients with bronchiectasis and reduce the heart rate and respiratory rate of patients.