加温湿化经鼻高流量氧疗对急性Ⅰ型呼吸衰竭患者的影响  

Effect of warm humidification transnasal high flow oxygen therapy on patients with acute type Ⅰ respiratory failure

作　　者：孙小强[1] SUN Xiaoqiang(Department of Critical Care Medicine,Ji'nan Third People's Hospital,Shandong Province,Ji'nan250101,China)

机构地区：[1]山东省济南市第三人民医院重症医学科,山东济南250101

出　　处：《中国当代医药》2023年第3期72-74,78,共4页China Modern Medicine

摘　　要：目的探讨加温湿化经鼻高流量氧疗(HFNC)对急性Ⅰ型呼吸衰竭患者的影响。方法选择2019年4月至2022年4月济南市第三人民医院收治的82例急性Ⅰ型呼吸衰竭患者,采用随机数字表法分为对照组与研究组,每组各41例。对照组采用无创通气(NIV)治疗,研究组采用加温湿化HFNC。对比两组血流动力学、呼吸功能、氧合指数(OI),并随访3个月,记录两组复发情况。结果治疗前,两组患者的呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、OI指标比较,差异无统计学意义(P>0.05);治疗后24 h,两组患者的RR、HR、MAP指标均低于本组治疗前,PaO_(2)、OI指标高于本组治疗前,且研究组的RR、HR、MAP指标低于对照组,PaO_(2)、OI指标高于对照组,差异有统计学意义(P<0.05);治疗后24 h,两组患者的PaCO_(2)指标比较,差异无统计学意义(P>0.05);研究组的复发率低于对照组,差异有统计学意义(P<0.05)。结论加温湿化HFNC能够改善急性Ⅰ型呼吸衰竭患者OI及呼吸功能,促进血流动力学指标复常,降低复发风险,临床应用价值更高。Objective To explore the effect of warm humidification transnasal high flow oxygen therapy(HFNC)on patients with acute typeⅠrespiratory failure.Methods A total of 82 patients with acute typeⅠrespiratory failure admitted to Ji'nan Third People's Hospital from April 2019 to April 2022 were divided into two groups according to random number table method,with 41 patients in each group.The control group was treated with non-invasive ventilation(NIV),and the study group was treated with warming and humidification HFNC.The hemodynamics,respiratory function and oxygenation index(OI)of the two groups were compared and followed up for 3 months.The recurrence of the two groups was recorded.Results Before treatment,there were no significant differences in respiratory rate(RR),heart rate(HR),mean arterial pressure(MAP),arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2))and OI between the two groups(P>0.05).At 24 h after treatment,the RR,HR and MAP indexes of the two groups were lower than those before treatment,and the PaO_(2)and OI indexes were higher than those before treatment,and the RR,HR and MAP indexes of the study group were lower than those of the control group,and the PaO_(2)and OI indexes were higher than those of the control group,with statistically significant differences(P<0.05).At 24 h after treatment,there was no statistically significant difference in PaCO_(2)indexes between the two groups(P>0.05).The recurrence rate of the study group was lower than that of the control group,with statistically significant difference(P<0.05).Conclusion Warming and humidifying HFNC can improve OI and respiratory function of patients with acute typeⅠrespiratory failure,promote the normalization of hemodynamic indexes,reduce the risk of recurrence,and have higher clinical application value.

关 键 词：急性Ⅰ型呼吸衰竭 加温湿化经鼻高流量氧疗 无创通气 呼吸功能 氧合指数 

分 类 号：R563.8[医药卫生—呼吸系统]