Comparative Study Of High-flow Nasal Cannula Oxygen Therapy And Noninvasive Position Pressure Ventilation In The Patients With AECOPD Type Ⅱ Respiratory Failure Complicated With Thick Sputum

Objective:To compare the clinical efficacy of high-flow nasal cannula oxygen therapy and noninvasive position pressure ventilation in the treatment of patients with AECOPD type II respiratory failure（7.35>PH>7.25、 80mm Hg>Pa CO₂>50mm Hg）complicated with thick sputum.Methods:A total of 70 patients with AECOPD type II respiratory failure admitted to the Department of Respiratory and critical Medicine in Fenyang Hospital of Shanxi Province from November 2020 to February 2022 were randomly divided into HFNC group（n=35）and NPPV group（n=35）.Compare two groups before and after treatment in patients with sputum viscosity,expectoration difficult,cough symptom score,Borg dyspnea score,PH,Pa CO₂,Pa O₂,hospitalization time and intubation rate.Results:48 hours after admission,sputum viscosity,expectoration difficulty,cough symptom score and Brog dyspnea score in both groups were significantly lower than those before treatment（P<0.05）.Sputum viscosity,expectoration difficulty,cough symptom score and Brog dyspnea score in HFNC group were significantly lower than those in NPPV group（P<0.05）.At24 and 48 hours after admission,PH and Pa O₂in both groups were higher than those before treatment,while Pa CO₂was lower than that before treatment（P<0.05）.There was no significant difference in PH,Pa CO₂and Pa O₂between the two groups（P>0.05）.In terms of outcome,the hospitalization time of HFNC group was shorter than that of NPPV group（P<0.05）,there was no significant difference in intubation rate between the two groups（P>0.05）.Conclusion:In the patients with AECOPD type II respiratory failure（7.35>PH>7.25、80mm Hg>Pa CO₂>50mm Hg）complicated with thick sputum,compared with NPPV,HFNC can reduce the symptoms of cough,sputum and dyspnea and reduce the hospitalization time.Meanwhile,there was no significant difference between HFNC and NPPV in improving respiratory failure and reducing intubation rate.Therefore,HFNC can be recommended as the first choice in patients with AECOPD type II respiratory failure（7.35>PH>7.25、80mm Hg>Pa CO₂>50mm Hg）Complicated with thick sputum.