经鼻高流量鼻导管湿化氧疗对急性呼吸衰竭的临床疗效分析

Clinical efficacy of humidified high-flow nasal cannula oxygen therapy in treatment of acute respiratory failure

目的探讨经鼻高流量鼻导管湿化氧疗(HFNC)治疗急性呼吸衰竭的临床疗效。方法收集40例急性呼吸衰竭患者的临床资料,按其氧疗方式分为HFNC组(20例)和鼻导管常规氧疗组(对照组,20例)。比较治疗前和治疗24 h时2组患者的心率、呼吸频率、pH值、PaCO_2、氧合指数,评价2组的湿化满意率。结果治疗前,HFNC组和对照组间的心率、呼吸频率、pH值、PaCO_2和氧合指数比较差异均无统计学意义(P均> 0.05)。治疗24 h时,HFNC组患者的心率、呼吸频率、pH值、PaCO_2、氧合指数均较治疗前改善,对照组患者的心率、呼吸频率、氧合指数均比治疗前改善(P均<0.05);HFNC组的心率、呼吸频率、pH值、氧合指数均优于对照组(P均<0.05)。HFNC组的湿化满意率为90%,高于对照组的25%(χ~2=17.289,P <0.001)。结论急性呼吸衰竭患者使用HFNC的效果优于鼻导管常规氧疗。

Objective To evaluate the clinical efficacy of humidified high-flow nasal cannula oxygen therapy(HFNC) in the treatment of acute respiratory failure. Methods Clinical data of 40 patients with acute respiratory failure were collected. All patients were assigned into the HFNC(n=20)and routine oxygen therapy(control group, n=20)groups. The heart rate, respiratory rate, pH, CO2 partial pressure(PaCO2), oxygenation index were assessed before and 24 h after corresponding treatment. The satisfactory degree with the humidification effect was compared between two groups. Results Prior to treatment, the heart rate, respiratory rate, pH, PaCO2 and oxygenation index did not significantly differ between two groups( all P > 0.05). At 24 h post-treatment, the heart rate, respiratory rate, pH, PaCO2 and oxygenation index were significantly improved in the HFNC group, and the heart rate, respiratory rate and oxygenation index were considerably enhanced in the control group(all P < 0.05). In the HFNC group, the heart rate, respiratory rate, pH and oxygenation index were significantly better than those in the control group(all P < 0.05). In the HFNC group, the satisfactory degree with the humidification effect was 90%, significantly higher compared with 25% in the control group(χ 2=17.289, P < 0.001). Conclusion HFNC yields higher clinical efficacy in the management of acute respiratory failure compared with routine oxygen therapy.