经鼻高流量氧疗对胸部创伤致急性呼吸衰竭患者的疗效研究  

Efficacy of High-Flow Nasal Oxygen Therapy in Patients with Acute Respiratory Failure Due to Chest Trauma

作　　者：王爱民 朱广兵 WANG Aimin;ZHU Guangbing(Department of Critical Care Medicine,The First People's Hospital of Taicang City,Taicang 215400,China)

机构地区：[1]太仓市第一人民医院重症医学科,江苏太仓215400

出　　处：《中华灾害救援医学》2025年第1期65-68,共4页Chinese Journal of Disaster Medicine

基　　金：苏州市中西医结合科研基金项目(SYWD2024329)。

摘　　要：目的探讨胸部创伤致急性呼吸衰竭患者应用经鼻高流量氧疗的疗效,并进一步探索其优势。方法回顾性分析2019年3月至2023年3月太仓市第一人民医院收治的120例胸部创伤致急性呼吸衰竭的患者的临床资料。根据氧疗方式的差异分为观察组(经鼻高流量氧疗,60例)和对照组(常规氧疗,60例)。比较分析两组患者血气相关指标、肺功能相关指标、呼吸力学相关指标、临床疗效情况。结果治疗前,比较两组患者血气相关指标:动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))、pH值,肺功能相关指标:呼气流量峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气量(FEV1),呼吸力学相关指标:气道峰压(PIP)、气道阻力(Raw)以及气道平台压(Pplat),各项指标均无显著差异(P>0.05)。治疗后,两组患者以上血气相关指标、肺功能相关指标、呼吸力学相关指标均明显改善(P<0.05);且观察组患者PaCO_(2)、Pplat、Paw水平明显低于对照组(P<0.001),PaO_(2)、SpO_(2)、pH值、PEF、FEV1、FVC、PIP明显高于对照组(P<0.001)。观察组患者临床有效率高于对照组(P<0.05)。结论经鼻高流量氧疗联合及时有效的救治手段,可有效改善胸部创伤致急性呼吸衰竭患者的血气指标,一定程度上提升肺功能和呼吸功能,临床疗效优于常规氧疗。Objective To investigate the efficacy of high-flow nasal oxygen therapy in patients with acute respiratory failure due to chest trauma,and to further explore its advantages.Methods A retrospective analysis was conducted on the clinical data of 120 patients with acute respiratory failure secondary to chest trauma admitted to Taicang First People's Hospital between March 2019 and March 2023.Based on the differences in oxygen therapy methods,patients were divided into an observation group(high-flow nasal oxygen therapy,n=60)and a control group(conventional oxygen therapy,n=60).Comparative analyses were performed on blood gas parameters,pulmonary function indicators,respiratory mechanics metrics,and clinical outcomes between the two groups.Results Prior to treatment,there were no significant differences between the two groups regarding blood gas parameters,which included arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SpO_(2)),and pH value.Additionally,pulmonary function indicators such as peak expiratory flow(PEF),forced vital capacity(FVC),and forced expiratory volume in one second(FEV1),along with respiratory mechanics metrics like peak inspiratory pressure(PIP),airway resistance(Raw),and plateau pressure(Pplat),also showed no significant variation(P>0.05).After treatment,all of these indicators demonstrated significant improvement in both groups(P<0.05).Moreover,the observation group showed significantly lower levels of arterial partial pressure of carbon dioxide,plateau pressure,and airway pressure compared to the control group(P<0.001).Conversely,the observation group exhibited significantly higher levels of arterial partial pressure of oxygen,blood oxygen saturation,pH value,peak expiratory flow,forced expiratory volume in one second,forced vital capacity,and peak inspiratory pressure(P<0.001).The clinical efficacy rate observed in the observation group was higher than that in the control group(P<0.05).Conclusion High-flow nasal oxygen

关 键 词：胸部创伤 急性呼吸衰竭 经鼻高流量氧疗 

分 类 号：R264[医药卫生—中医外科学]