经鼻高流量氧疗临床麻醉应用的研究进展

Research Progress in Clinical Anesthesia Application of High-flow Nasal Oxygen Therapy

经鼻高流量氧疗(HFNO)是一种新兴的氧疗方式,近年来在临床得到广泛应用。其通过鼻塞导管持续地输送浓度相对恒定的加温湿化的高流量气体,具有很好的舒适性。HFNO能通过输送高流量气体产生一定水平的呼气末正压,冲刷上呼吸道生理无效腔,恒温恒湿的气体维持黏液纤毛清除系统功能以及降低患者上气道阻力和呼吸功等作用改善氧合状态。目前在临床麻醉领域,HFNO越来越多地应用于围插管期、消化内镜诊疗、上呼吸道手术等。虽然HFNO是一项应用广泛的新技术,但其临床疗效不一,具有一定局限性,尚需大规模研究进一步证实。

High-flow nasal oxygen therapy(HFNO)is a new approach of oxygen therapy,and has been widely used in clinical practice in recent years.HFNO provides comfort by continuously delivering a relatively constant concentration of heated and humidified high flow oxygen through a nasal cannula.It can improve oxygenation by delivering high-flow oxygen to produce a certain level of positive end-expiratory pressure,flushing the physiological dead space of the upper respiratory tract,maintaining the function of mucociliary clearance system with constant temperature and humidity,and reducing upper airway resistance and respiratory work.At present,in the field of clinical anesthesia,HFNO is increasingly used in peri-intubation period,digestive endoscopic diagnosis and treatment,upper respiratory tract surgery,etc.HFNO is a new technique with wide application,but its clinical efficacy is different and has some limitations,and large-scale studies are still needed for further validation.