许迎辉 李响 李哲勇 徐丹 马嘉

[摘要]目的 探讨经鼻高流量湿化氧疗在急性呼吸衰竭中的应用效果。方法 选取2015年12月～2017年12月我院收治的急性呼吸衰竭患者88例，采用随机数字表法将其分为对照组、观察组，每组44 例。对照组患者实施常规吸氧疗法，观察组患者实施经鼻高流量湿化氧疗，比较两组患者的血气指标、治疗时间、不良事件发生率的情况。结果 治疗后，两组患者的呼吸频率、PaCO2、心率指标均低于治疗前，且PaO2、SpO2指标均高于治疗前，差异均有统计学意义（P<0.05）；观察组患者治疗后的呼吸频率、PaCO2、心率指标均低于对照组，且PaO2、SpO2指标均高于对照组，差异均有统计学意义（P<0.05）。观察组患者ICU停留时间、住院时间均短于对照组，且观察组患者的机械通气使用率低于对照组，差异均有统计学意义（P<0.05）。观察组患者的不良事件发生率低于对照组，差异有统计学意义（P<0.05）。结论 经鼻高流量湿化氧疗可改善急性呼吸衰竭患者的血气指标，缩短治疗时间并提高安全性。

[关键词]经鼻高流量湿化氧疗；急性呼吸衰竭；血气指标；安全性

[中图分类号] R654 [文献标识码] A [文章编号] 1674-4721（2018）8（c）-0075-03

[Abstract] Objective To investigate the effect of nasal high flow humidified oxygen therapy in acute respiratory failure. Methods A tolal of 88 patients with acute respiratory failure admitted to our hospital from December 2015 to December 2017 were selected and divided into control group and observation group with 44 cases in each group by random number table method. Patients in the control group were given conventional oxygen therapy while patients in the observation group were given nasal high flow humidified oxygen therapy. The blood gas index， treatment time and incidence of adverse events were compared between the two groups. Results After treatment， the respiratory rate， PaCO2 and heart rate indexes of the two groups were lower than those before treatment， and PaO2， and SpO2 indexes were higher than those before treatment， the differences were statistically significant （P<0.05）. The respiratory rate， PaCO2， and heart rate indexes of the observation group were lower than those of the control group after treatment， and the PaO2， and SpO2 indexes were higher than those of the control group， the differences were statistically significant （P<0.05）. The ICU stay time and hospitalization time of patients in the observation group were shorter than those in the control group， and the utilization rate of mechanical ventilation of patients in the observation group was lower than that in the control group， the differences were statistically significant （P<0.05）. The incidence of adverse events in the observation group was lower than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion Transnasal high flow humidified oxygen therapy can improve the blood gas index of patients with acute respiratory failure， shorten the treatment time and improve the safety.

[Key words] Nasal high flow humidified oxygen therapy； Acute respiratory failure； blood gas index； Safety

急性呼吸衰竭是臨床常见病，可影响到全身各个器官的机能代谢，引发不同程度的低血氧症，如果不能给予患者及时有效的对症处理，将有可能直接危及患者的预后[1-3]。氧疗可通过提高输入气体中的氧气含量，以达到缓解或纠正患者体内缺氧状态，进而改善机体氧供，是临床治疗急性呼吸衰竭的一线疗法[4-6]。传统疗法主要为鼻导管法和面罩法，虽然可在一定程度上缓解患者的氧供，当氧流量有限，且吸入氧气的体积分数却不稳定，容易受到呼吸类型和呼吸流速的影响。如何提高氧疗效果，一直是临床医生关注的热点问题。此次研究对44例急性呼吸衰竭患者实施经鼻高流量湿化氧疗，取得了显著疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年12月～2017年12月我院收治的急性呼吸衰竭患者88例，采用随机数字表法将其分为对照组、观察组，每组44 例。……