经鼻高流量氧疗在治疗重症肺炎合并急性呼吸窘迫综合征患者中的应用  

Application of transnasal high flow oxygen therapy in severe pneumonia with acute respiratory distress syndrome

作　　者：郑华[1] 胡亚兰[1] 张绵[1] 曾东[1] ZHENG Hua;HU Yalan;ZHANG Jin;ZENG Dong(Department of Critical Medicine,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450016,China)

机构地区：[1]郑州市第七人民医院重症医学科,郑州450016

出　　处：《上海医药》2022年第7期58-61,65,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：河南省医学科技攻关计划项目(2018020852)。

摘　　要：目的:探讨经鼻高流量氧疗治疗重症肺炎合并急性呼吸窘迫综合征的效果。方法:将110例重症肺炎合并急性呼吸窘迫综合征患者随机分为对照组(n=55)和观察组(n=55)。治疗2周时,对比治疗前后痰液黏稠度、血气指标及心肺功能指标,统计疗效及并发症情况。结果:观察组总有效率高于对照组(92.73%vs 78.18%,P<0.05);治疗后,观察组痰液黏稠度Ⅱ级比例、pH、氧合指数、用力肺活量(FVC)、1秒用力呼气量(FEV_(1))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。两组心率、平均动脉压和并发症发生情况无统计学差异(P>0.05)。结论:重症肺炎合并急性呼吸窘迫综合征经鼻高流量氧疗治疗可改善患者的血气及肺功能,缓解呼吸困难症状。Objective:To investigate the effect of transnasal high flow oxygen therapy on severe pneumonia complicated with acute respiratory distress syndrome.Methods:One hundred and ten patients with severe pneumonia complicated with acute respiratory distress syndrome were randomly divided into a control group(n=55)and an observation group(n=55).After 2 weeks of treatment,sputum consistency,blood gas and cardiopulmonary function were compared before and after treatment and efficacy and complication were analyzed.Results:The overall response rate in the observation group was higher than that in the control group(92.73%vs 78.18%,P<0.05).After treatment,the sputum consistency Ⅱ ratio,pH,oxygenation index,forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1))were higher but PaCO_(2) was lower in the observation group than the control group(P<0.05).There were no significant differences in heart rate,mean arterial pressure and complications between the two groups(P>0.05).Conclusion:Transnasal high flow oxygen therapy for severe pneumonia complicated with acute respiratory distress syndrome can improve blood gas and lung function and relieve dyspnea symptoms.

关 键 词：重症肺炎 急性呼吸窘迫综合征 经鼻高流量氧疗 无创正压通气 心肺功能 并发症 

分 类 号：R459.6[医药卫生—治疗学] R563.1[医药卫生—临床医学]