经鼻高流量氧疗在不同原因呼吸衰竭患者中的临床疗效分析  

Analysis of the effect of high-flow nasal cannula oxygen therapy on patients with respiratory failure caused by different causes

作　　者：李幼霞 邓西龙[1] 黄煌[1] 蔡水江 刘莹 刘勇进 梁桐 LI You-xia(Department of Critical Care Medicine,No.8 People＇s Hospital of Guangzhou,Guangzhou,Guangdong,510060,China.)

机构地区：[1]广州市第八人民医院重症医学科,510060

出　　处：《齐齐哈尔医学院学报》2018年第12期1394-1397,共4页Journal of Qiqihar Medical University

基　　金：2014年至2017年广州市健康医疗协同创新重大专项之"呼吸道新发突发及重大传染病综合防诊治(201400000002)"

摘　　要：目的探讨经鼻高流量氧疗(HFNC)在不同原因呼吸衰竭患者的临床应用效果。方法回顾性分析2016年5月—2017年11月期间广州市第八人民医院综合ICU收治34例接受HFNC的不同原因呼吸衰竭患者病例资料。根据HFNC治疗是否有效将其分为有效组和无效组,比较两组患者的血气结果及临床指标等。结果 HFNC治疗有效率为82.35%。无效组使用HFNC前APACHⅡ评分为(21.00±3.52)分,大于有效组的(15.29±5.62)分;无效组RR值为(33.17±6.74)次/min,大于有效组(24.93±6.39)次/min;有效组MAP为(88.89±10.97)mm Hg,大于无效组(73.83±9.04)mm Hg;有效组氧合指数(OI)(224.32±58.60),大于无效组OI(163.13±49.22),差异均有统计学意义(P<0.05)。HFNC有效组肺泡动脉氧分压差(A-aDO2)、心率、呼吸在HFNC治疗后明显改善,差异有统计学意义(P<0.05)。结论 HFNC可作为轻中度ARDS、心功能不全所致低氧血症患者的一线呼吸支持治疗手段。Objective To investigate the clinical effect of the high-flow nasal cannula oxygen therapy on patients with respiratory failure caused by different causes. Methods From May 2016 to November 2017,34 cases of patients hospitalized in the ICU of Guangzhou No. 8 People ＇s Hospital received HFNC treatment were enrolled in this study,the clinical data of them were retrospective analyzed. According to HFNC treatment effect,they were divided into effective and invalid group,results of blood gas and clinical indicators of the two groups of patients were compared.Results The success rate of HFNC was 82.35%. Before the use of HFNC,APACHE II score of invalid group（ 21±3.52） was greater than that of the effective group（ 15. 29 ± 5. 62）. RR in the invalid group（ 33.17±6. 74/min） was greater than that in the effective group（ 24. 93 ± 6. 39/min）. The MAP of the effective group（ 88. 89 ± 10. 97 mm Hg） was greater than that of the invalid group（ 73. 83 ± 9. 04 mm Hg）.Oxygenation index（ OI） in the effective group（ 224.32 ± 58.6） was greater than that of the invalid group（ 163.13±49.22）,the differences were statistically significant（ P 0. 05）. The alveolar oxygen partial pressure（ A-aDO2）,heart rate,and respiration in the effective group were significantly improved after HFNC treatment,and the differences were statistically significant（ P 0. 05）. Conclusions HFNC can be used as a first-line respiratory support treatment for patients with mild to moderate ARDS and hypoxemia due to cardiac insufficiency.

关 键 词：经鼻高流量氧疗 湿化 氧疗 呼吸衰竭 

分 类 号：R563[医药卫生—呼吸系统]