经鼻高流量湿化氧疗在急性左心衰竭竭患者急诊急救中的应用价值分析  

Application value of transnasal high flow humidification oxygen therapy in emergency treatment of patients with acute left heart failure

作　　者：李筱姝 李志民 许哲 王彧娇 李志强[1] LI Xiaoshu;LI Zhimin;XU Zhe;WANG Yujiao;LI Zhiqiang(Department of Emergency,Capital Medical University Mentougou Teaching Hospital,Beijing 102300,China)

机构地区：[1]首都医科大学门头沟教学医院急诊科,102300

出　　处：《心肺血管病杂志》2022年第4期344-347,364,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨经鼻高流量湿化氧疗(HFNC)技术在急性左心衰竭患者急诊急救中的应用价值。方法:回顾性分析我院急诊科收治的急性左心衰竭竭患者64例,随机分组为非高流量氧疗组(面罩吸氧,无创呼吸机治疗)38例和高流量氧疗组26例,两组均给与常规的抗心力衰竭药物治疗。比较两组治疗前与治疗后2h、6h、12h的呼吸频率、心率、氧合指数(PaO_(2)/FiO_(2))、平均动脉压的变化情况;比较两组治疗前与治疗后6h、12h的血中BNP水平。结果:治疗后2h、6h、12h两组患者呼吸频率、心率、平均动脉压、BNP水平较治疗前明显下降,氧合指数改善,且差异有统计学意义(P<0.05)。治疗后6h、12h呼吸频率及治疗后2h、6h的心率,两组间差异有统计学意义(P<0.05);治疗后6h平均动脉压及治疗后2h氧合指数,组间差异有统计学意义(P<0.05)。BNP在治疗前及治疗后6h、12h观察,两组间差异无统计学意义(P>0.05)。HFNC组无效2例,总有效率92.3%,非HFNC组无效4例,总有效率89.5%,两组差异无统计学意义(P>0.05)。结论:HFNC在急性左心衰竭患者的急诊急救中,与传统氧疗及无创通气临床疗效相似,且操作便捷、耐受性好,值得在急诊科推广应用。Objective:To explore the application value of nasal high-low nasal cannula oxygen therapy(HFNC)in emergency treatment of patients with acute left heart failure.Methods:64 patients with acute left heart failure admitted to the emergency department of our hospital were retrospectively analyzed.They were randomly divided into non high flow oxygen therapy group(mask oxygen,noninvasive ventilator treatment)with 38 cases and HFNC group with 26 cases.Both groups were given conventional anti heart failure drugs.The changes of respiratory rate,heart rate,oxygenation index(PaO_(2)/FiO_(2))and mean arterial pressure(MAP)were compared between the two groups before and 2h,6h and 12h after treatment.The levels of BNP were compared between the two groups before treatment and 6h and 12h after treatment.Results:The respiratory rate,heart rate(MAP and BNP of the two groups at 2h)6hand 12h after treatment were significantly lower than those before treatment(P<0.05);There were significant differences in respiratory rate at 6h and 12h after treatment and heart rate at 2h and 6h after treatment between the two groups(P<0.05).There were significant differences in mean arterial pressure 6 hours after treatment and oxygenation index 2 hours after treatment(P<0.05).There was no significant difference in BNP between the two groups before treatment and 6h and 12h after treatment.The total effective rate was 92.31%in HFNC group(one patient died and one patient turned to invasive ventilation)and 89.47%in non HFNC group(one patient died,two patients were intolerable,and one patient was converted to invasive ventilation).There was no significant difference between the two groups(P>0.05).Conclusions:HFNC has similar clinical efficacy with traditional oxygen therapy and noninvasive ventilation in the emergency treatment of patients with acute left heart failure,and it is easy to operate and well tolerated,which is worthy of promotion and application in the emergency department.

关 键 词：经鼻高流量湿化氧疗 急性左心衰竭 急诊急救 

分 类 号：R54[医药卫生—心血管疾病]