急诊床旁肺部超声联合经鼻高流量氧疗在急性呼吸困难合并低氧血症患者中的治疗效果  

Therapeutic Effect of Emergency Bedside Pulmonary Ultrasound Combined with Nasal High Flow Oxygen Therapy in the Treatment of Patients with Acute Dyspnea and Hypoxemia in Emergency Department

作　　者：沈军华 胡瑞华 梁旭义 SHEN Junhua;HU Ruihua;LIANG Xuyi(Department of Emergency,Guangzhou General Hospital of Foresea Life Insurance,Guangzhou 511300,Guangdong,China)

机构地区：[1]前海人寿广州总医院急诊科,广东广州511300

出　　处：《世界复合医学（中英文）》2024年第9期183-186,共4页World Journal of Complex Medicine

摘　　要：目的探讨急诊床旁肺部超声联合经鼻高流量氧疗(high-flow nasal cannula,HFNC)在急性呼吸困难合并低氧血症患者中的治疗效果。方法选取2021年8月—2023年12月前海人寿广州总医院收治的90例急性呼吸困难合并低氧血症患者为研究对象,按照治疗方法不同将患者分为对照组和研究组,各45例。对照组采用床旁肺部超声指导下传统氧疗,研究组采用床旁肺部超声联合HFNC治疗。比较两组患者血氧饱和度(blood oxygen saturation,SpO_(2))、二氧化碳分压(partial pressure of carbon dioxide,PCO_(2))、氧合指数[动脉氧分压(partial pressure of oxygen in artery,PaO_(2))/吸入氧浓度(fraction of inspiration O_(2),FiO_(2))]及气道湿化效果(咳痰难易程度及痰液性状)。结果治疗后,两组SpO_(2)、PaO_(2)/FiO_(2)均升高,且研究组高于对照组,差异有统计学意义(P均<0.05)。两组PCO_(2)均降低,且研究组低于对照组,差异有统计学意义(P<0.05)。两组患者咳痰难易程度评分及痰液性状评分均降低,研究组咳痰难易程度评分为(1.31±0.29)分、痰液性状评分为(1.63±0.35)分,均低于对照组的(2.17±0.34)分、(2.18±0.44)分,差异有统计学意义(t=12.910、6.562,P均<0.05)。结论急诊床旁肺部超声联合经鼻高流量氧疗能够有效改善患者血气指标与气道湿化效果。Objective To explore the therapeutic effect of bedside emergency pulmonary ultrasound combined with high-flow nasal cannula(HFNC)in patients with acute dyspnea and hypoxemia.Methods A total of 90 patients with acute dyspnea and hypoxemia admitted to the Guangzhou General Hospital of Foresea Life Insurance from August 2021 to December 2023 were selected as the research objects.According to different treatment methods,the patients were divided into control group and study group,with 45 cases in each group.The control group was treated with traditional oxygen therapy under the guidance of bedside lung ultrasound,and the study group was treated with bedside emergency lung ultrasound combined with HFNC.The blood oxygen saturation(SpO_(2)),partial pressure of carbon dioxide(PCO_(2))and oxygenation index[partial pressure of oxygen in artery(PaO_(2))/fraction of inspiration O_(2)(FiO_(2))]and airway humidification effect(difficulty of expectoration and sputum characteristics)were compared between the two groups.Results After treatment,the SpO_(2) and PaO_(2)/FiO_(2) of the two groups increased,and that of the study group were higher than those of the control group,and the differences were statistically significant(both P<0.05).The PCO_(2) of the two groups decreased,and the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The scores of sputum difficulty and sputum traits in the two groups decreased,and the scores of sputum difficulty and sputum traits in the study group were(1.31±0.29)points and(1.63±0.35)points,which were lower than(2.17±0.34)points and(2.18±0.44)points in the control group,and the differences were statistically significant(t=12.910,6.562,both P<0.05).Conclusion Emergency bedside lung ultrasound combined with nasal highflow oxygen therapy can effectively improve the blood gas index and airway humidification effect of patients.

关 键 词：经鼻高流量氧疗 血气分析 急性呼吸困难 低氧血症 肺部超声 

分 类 号：R563[医药卫生—呼吸系统]