经鼻高流量氧疗用于急性低氧性呼吸衰竭的效果观察

Clinical observation on high flow nasal cannula therapy in acute hypoxic respiratory failure patients

目的 探讨经鼻高流量氧疗（HFNC）在急性低氧性呼吸衰竭（AHRF）患者中的应用价值.方法 回顾性分析2016年1月至2018年4月常德市第一人民医院58例成人AHRF患者的临床资料,58例中接受HFNC治疗者30例,接受面罩通气（FM）治疗者28例.比较两组患者治疗前一般情况及治疗后临床指标.结果 两组患者年龄、性别、治疗前APACHEⅡ评分、心率、呼吸频率、平均动脉压（mmHg）、动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、氧合指数比较差异未见统计学意义（P〉0.05）.治疗2 h后,HFNC组PaO2、氧合指数高于FM组（P〈0.05）,HFNC组心率及呼吸频率低于FM组（P〈0.05）,两组平均动脉压及PaCO2比较差异未见统计学意义（P〉0.05）.住院期间HFNC组治疗失败率低于FM组（P〈0.05）.结论 HFNC可改善AHRF患者临床症状及氧合状况,是一种安全、有效的呼吸支持手段.

Objective To evaluate the effect of high flow nasal cannula therapy （ HFNC ） in acute hypoxic respiratory failure （ AHRF） patients.Methods The data of 58 cases of adult AHRF patients in the First People＇s Hospital of Changde from January 2016 to April 2018 were retrospectively analyzed .The 30 patients were treated with HFNC and 28 patients were treated with mask ventilation （ FM） .The general conditions and clinical indicators before and after treatment were compared between the two groups.Results There was no significant difference in clinical features such as age , gender, APACHEⅡ score, heart rate, respiratory rate, mean arterial pressure , oxygenation index , PaO2 and PaCO2 between the two groups before treatment （ P 〉0.05 ） .Two hours after treatment , PaO2 and oxygenation index in HFNC group were higher than those in FM group （ P 〈0.05）.Heart rate and respiratory rate in HFNC group were lower than that in FM group （ P〈0.05 ） .There was no significant difference in mean arterial pressure or PaCO 2 level between the two groups after treatment （ P〉0.05 ） . In HFNC group , the treatment failure rate during hospitalization was lower than that in FM group （ P〈0.05 ） .Conclusions HFNC can improve the clinical symptoms and oxygenation of patients with AHRF, it is a safe and effective means of breathing support .