经鼻高流量湿化氧疗在轻度急性呼吸窘迫综合征中的应用价值  

The value of high flow nasal cannula in the treatment of mild acute respiratory distress syndrome caused by acute pancreatitis

作　　者：李刚[1] 李国楠 王二宁 王凯进 张洪波[1] 孙力超[1] 张国强[1] LI Gang;LI Guo-nan;WANG Er-ning

机构地区：[1]中日友好医院急诊科,北京100029 [2]陕西省渭南市中心医院急诊科,陕西渭南714000 [3]陕西省渭南市临渭区中医院,陕西渭南714000

出　　处：《中日友好医院学报》2020年第5期259-262,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨经鼻高流量湿化氧疗(HFNC)在轻度急性呼吸窘迫综合征(ARDS)中的治疗价值。方法:选择2019年1月~2020年4月中日友好医院收治的急性胰腺炎(AP)所致轻度ARDS的患者80例,随机分为常规氧疗组和HFNC组,在常规治疗及抗菌治疗基础上,分别使用普通氧气面罩氧疗和HFNC,观察2组患者治疗前和治疗后3h、24h的呼吸频率(RR)、呼吸困难视觉量表(VAS)、氧合指数(OI)、心率(HR);治疗前和治疗后72h的炎症指标、肺部影像;并进行随访。结果:治疗后2组患者的RR、OI、呼吸困难VAS、HR均较治疗前改善,HFNC组在3h、24h时均优于常规治疗组(均P<0.01)。治疗前2组患者血清炎症指标均高于正常参考值,治疗72h后均较治疗前下降,HFNC组下降更显著(均P<0.05)。治疗72h后,2组患者肺水肿均减轻好转,HFNC组好转率高于常规氧疗组(P<0.05),HFNC组的ARDS持续时间、腹痛缓解时间、平均住院周期均较常规氧疗组显著缩短(均P<0.05)。结论:在AP所致轻度ARDS患者中,HFNC较普通面罩氧疗能更好改善多项临床指标,具有更好的临床应用价值。Objective:To define the value of high flow nasal cannula in the treatment of mild acute respiratory distress syndrome(ARDS).Methods:A total of 80 patients with mild ARDS caused by acute pancreatitis admitted to our hospital from Jan.2019 to Apr.2020 were selected.The patients were divided into group A and high flow nasal cannula(HFNC)group by the random number table method.Both groups were given routine medical treatment and antibacterial treatment as required.Group A was treated with ordinary oxygen mask for oxygen inhalation,while the HFNC group was treated with high flow nasal oxygen inhalation.The respiratory rate(RR),dyspnea visual analogue scale(VAS),oxygenation index(OI)and heart rate(HR)of the patients in the two groups before treatment and at 3 h and 24 h after treatment were observed.Inflammatory response indexes and pulmonary images were recorded before treatment and 72 h after treatment.Results:There was no statistically significant difference in RR,OI,dyspnea VAS and HR between the two groups before treatment.All indicators above in the two groups were improved after treatment and significantly better in the HFNC group than those in group A at 3 h and 24 h of treatment(all P<0.01).After 72 h of treatment,pulmonary edema was reduced in both groups,and the recovery rate of the HFNC group was higher than that in group A(P<0.05).The duration of ARDS,abdominal symptoms and the average hospitalization days were shorter in the HFNC group(P<0.05).Conclusion:In patients with mild ARDS,HFNC can improve a number of clinical indicators better than conventional oxygen therapy,and has better clinical application value.

关 键 词：经鼻高流量吸氧 氧疗 急性胰腺炎 急性呼吸窘迫综合征 

分 类 号：R459.7[医药卫生—急诊医学]