经鼻高流量氧疗治疗急性低氧性呼吸衰竭的疗效

Curative Effect of High-Flow Nasal Cannula Oxygen Therapy on Acute Hypoxic Respiratory Failure

目的探讨经鼻高流量氧疗治疗急性低氧性呼吸衰竭的临床疗效。方法将55例急性低氧性呼吸衰竭患者按随机双盲法分为3组:FM组(n=18)、HFNC组(n=18)和NPPV组(n=19)。FM组采用文丘里呼吸面罩进行氧气吸入,HFNC组采用呼吸湿化治疗仪行经鼻高流量氧疗,NPPV组采用无创呼吸机行经面罩无创正压通气。观察3组治疗前30min和治疗后2hpH、呼吸频率、心率(HR)、舒适度和动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)、动脉血氧饱和度(SpO_2)、平均动脉压(MAP)水平的变化。结果与同组治疗前30min比较,治疗后2h,HFNC组、NPPV组呼吸频率下降和PaO_2、SpO_2水平均升高,FM组PaO_2水平升高,NPPV组MAP水平下降,HFNC组舒适度评分升高(均P<0.05);与FM组比较,HFNC组、NPPV组治疗后2hPaO_2水平均升高(均P<0.05);与HFNC组比较,NPPV组治疗后2hPaO_2水平升高(P<0.05);与FM组、HFNC组比较,NPPV组治疗后2hMAP水平下降(P<0.05);与FM组、NPPV组比较,HFNC组治疗后2h舒适度评分升高(P<0.05)。结论经鼻高流量氧疗治疗急性低氧性呼吸衰竭具有较好的疗效,可纠正机体缺氧的状态,改善肺功能,并能提供很好的舒适度。

Objective To explore the clinical curative effect of high-flow nasal cannula oxygen therapy on acute hypoxic respiratory failure.Methods Fifty-five patients with acute hypoxic respiratory failure were randomly given Venturi face mask oxygen therapy（FM group,n=18）,humidified high-flow nasal cannula oxygen therapy（HFNC group,n=18）,or non-invasive positive pressure ventilation（NPPV group,n=19）.The pH,respiratory frequency,heart rate（HR）,comfort degree,arterial carbon dioxide partial pressure（PaCO2）,arterial oxygen partial pressure（PaO2）,arterial oxygen saturation（SpO2）and mean arterial pressure（MAP）were measured 30 minutes before treatment and 2 hours after treatment.Results At 2 hours after treatment,respiratory frequency decreased but PaO2 and SpO2 increased in HFNC and NPPV groups,PaO2 increased in FM group,MAP decreased in NPPV group,and comfort degree increased in HFNC group,compared with the parameters measured 30 minutes before treatment（P〈0.05）.Comparison with FM group,the PaO2 increased in HFNC and NPPV groups after treatment（P〈0.05）.Compared with HFNC group,the PaO2 increased in NPPV group after treatment（P〈0.05）.Compared with FM or HFNC group,the MAP decreased in NPPV group after treatment（P〈0.05）.Compared with FM or NPPV group,the comfort degree increased in HFNC group after treatment（P〈0.05）.Conclusion High-flow nasal cannula oxygen therapy can effectively correct hypoxia,improve lung function and enhance comfort in patients with acute hypoxic respiratory failure.