经鼻高流量氧疗对慢性心力衰竭急性加重患者安全性和有效性的临床研究  

Clinical study on the safety and efficacy of high-flow nasal cannula oxygen therapy in patients with acute exacerbation of chronic heart failure

作　　者：刘春彦 范亚林 李东旭 苏雪平 Liu Chunyan;Fan Yalin;Li Dongxu;Su Xueping(Training Section,Shijiazhuang Emergency Center,Hebei Province,Shijiazhuang 050024,China;Department of Emergency,the 980th Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China,Shijiazhuang 050024,China;Second Central Station,Shijiazhuang Emergency Center,Hebei Province,Shijiazhuang 050024,China;Communication Dispatch Department,Shijiazhuang Emergency Center,Hebei Province,Shijiazhuang 050024,China)

机构地区：[1]河北省石家庄市急救中心培训科,石家庄050024 [2]中国人民解放军联勤保障部队第九八〇医院急诊科,石家庄050024 [3]河北省石家庄市急救中心第二中心站,石家庄050024 [4]河北省石家庄市急救中心通讯调度科,石家庄050024

出　　处：《中国医药》2025年第2期176-180,共5页China Medicine

摘　　要：目的探讨经鼻高流量氧疗(HFNCO)对急诊慢性心力衰竭急性加重患者的效果及安全性。方法选择2020年1月1日至2021年12月31日中国人民解放军联勤保障部队第九八〇医院急诊收治的慢性心力衰竭急性加重患者63例,按照随机数字表法分为HFNCO组和无创呼吸机辅助通气(NIV)组。观察比较2组入急诊时以及离开急诊时一般情况、氧合指标以及心功能相关指标。结果离开急诊时HFNCO组动脉血二氧化碳分压显著低于NIV组[(38±4)mmHg(1 mmHg=0.133 kPa)比(41±5)mmHg](P=0.015)。与入急诊时相比,离开急诊时HFNCO组和NIV组患者动脉氧分压均明显改善[(74±8)mmHg比(68±9)mmHg、(75±7)mmHg比(69±12)mmHg](均P<0.05)。HFNCO组患者离开急诊时心脏指数、每搏输出量和每搏指数均明显低于NIV组(均P<0.05)。与入急诊时相比,离开急诊时HFNCO组和NIV组患者心输出量、心脏指数、每搏输出量和每搏指数均显著增加(均P<0.05)。2组通气成功比例和急诊室滞留时间比较,差异均无统计学意义(均P>0.05)。结论HFNCO能改善急诊慢性心力衰竭急性加重患者的氧合指标和心功能。Objective To investigate the efficacy and safety of high-flow nasal cannula oxygen therapy(HFNCO)in emergency patients with acute exacerbation of chronic heart failure.Methods A total of 63 patients with acute exacerbation of chronic heart failure admitted to the Department of Emergency,the 980th Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China from January 1,2020 to December 31,2021 were selected and divided into HFNCO group and non-invasive ventilation(NIV)group according to the random number table method.The general condition,oxygenation index and cardiac function related index were observed and compared between the two groups when they entered and left the emergency department.Results Arterial partial pressure of carbon dioxide was significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department[(38±4)mmHg vs(41±5)mmHg](P=0.015).Compared with those at the time of admission to the emergency department,the arterial oxygen partial pressure of patients in the HFNCO group and the NIV group was significantly improved at the time of leaving the emergency department[(74±8)mmHg vs(68±9)mmHg,(75±7)mmHg vs(69±12)mmHg](both P<0.05).Cardiac index,stroke volume,and stroke volume index were significantly lower in the HFNCO group than in the NIV group at discharge from the emergency department(all P<0.05).Cardiac output,cardiac index,stroke volume,and stroke volume index were significantly increased at the time of leaving the emergency department in both HFNCO and NIV groups compared with those at the time of admission(all P<0.05).There were no statistically significant differences in the success rate of ventilation and emergency room stay time between the two groups(both P>0.05).Conclusion HFNCO can improve oxygenation index and cardiac function in emergency patients with acute exacerbation of chronic heart failure.

关 键 词：慢性心力衰竭急性加重 经鼻高流量氧疗 无创机械通气 

分 类 号：R541[医药卫生—心血管疾病]