呼吸湿化治疗仪在急性左心衰竭发作患者中应用的初步探讨  

Preliminary study on the application of high-flow nasal cannula oxygen therapy in patients with acute left ventricular dysfunction

作　　者：叶龙彪 李彬 夏爽 YE Long-biao;LI Bin;XIA Shuang(Department of Emergency,Luhe County People′s Hospital,Shanwei,Guangdong 516700,China;Depart-ment of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]陆河县人民医院急诊科,广东汕尾516700 [2]广东省心血管病研究所心内科广东省人民医院(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2021年第2期180-183,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省医学科学技术研究基金项目(项目编号:A2017293)。

摘　　要：目的初步探讨经鼻高流量湿化氧疗(high-flow nasal cannula oxygen therapy,HFNC)对急性左心衰竭发作患者的辅助治疗作用。方法入选2018年12月至2020年6月间,陆河县人民医院急诊收治的急性左心衰竭患者共72例,年龄(73.61±9.47)岁,按随机数字表法随机分为2组:常规治疗组36例,其中男、女各18例,年龄(72.16±9.77)岁,采用传统抗心力衰竭治疗;HFNC组36例,其中男15例,女21例,年龄(74.11±8.32)岁,于传统抗心力衰竭治疗后2 h采用HFNC治疗。比较两组患者的治疗疗效。结果常规治疗组有5例(13.9%)患者需要气管插管上呼吸机治疗;而HFNC组仅1例(2.8%)患者需要气管插管上呼吸机治疗,两组比较差异有统计学意义(P<0.01)。治疗后,与常规治疗组比较,HFNC患者的心率及呼吸频率减慢,氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度降低,血氧饱和度和氧分压均升高,差异有统计学意义(P<0.01)。结论HFNC有助于急性左心衰竭患者生命征的稳定,在短期内提高患者的血氧饱和度及氧分压,降低NT-proBNP浓度,改善急性左心衰竭患者的短期症状。Objectives To detect the adjuvant therapy effect of the high-flow nasal cannula oxygen therapy(HFNC)in patients with acute left ventricular dysfunction.Methods From December 2018 to June 2020,a total of 72 patients with acute left ventricular dysfunction were selected in Luhe County People′s Hospital.The average age was(73.61±9.47)years.All the patients were randomly divided into two groups.There were 36 patients in routine treatment group(patients were treated by traditional anti-heart failure therapy),of which 18 cases of male and female,aged(72.16±9.77)years.The other 36 patients were in HFNC group(patients performed HFNC 2 h after traditional anti-heart failure therapy),of which 15 cases of male and 21 cases of female,aged(74.11±8.32)years.Therapy effect of the two group was compared.Results There were 5 cases(13.9%)requiring endotracheal intubation with ventilator in routine treatment group,but only 1 case(2.8%)in HFNC group,and the difference between the two groups was with signifi⁃cantly difference(P<0.01).After treatment,heart rate(HR)and breathing rate(R)significantly decreased,concen⁃tration of N-terminal pro-brain natriuretic peptide(NT-proBNP)significantly decreased,both oxygen saturation(SpO_(2))and partial oxygen pressure(PaO_(2))significantly increased in HFNC group when compared with those in routine treatment group(P<0.01).Conclusions HFNC contributes to the stability of life signs in patients with acute left heart failure.In the short term,it can improve the SpO_(2) and PaO_(2),reduce the concentration of NT-proBNP,and improve the short-term symptoms of patients with acute left heart failure.

关 键 词：心力衰竭 经鼻高流量湿化氧疗 氨基末端脑钠肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]