经鼻高流量氧疗治疗ICU急性心力衰竭对患者呼吸循环指标的影响

Effect of Nasal High-flow Oxygen Therapy on the Respiratory and Circulatory Indicators of Patients with Acute Heart Failure in ICU

目的探讨经鼻高流量氧疗治疗ICU急性心力衰竭对患者呼吸循环指标的影响。方法方便选取2021年1月—2022年12月厦门医学院附属第二医院收治的106例ICU急性心力衰竭患者为研究对象,以随机数表法将患者分成两组,每组53例。两组研究对象均接受强心、利尿、平喘、扩张血管等常规治疗,对照组接受无创正压通气治疗,观察组接受经鼻高流量氧疗治疗。两组均观察48 h。比较两组各项临床指标。结果治疗后,观察组呼吸频率、平均动脉压、二氧化碳分压(pressure of carbon dioxide,PaCO_(2))、视觉模拟评分法(Visual Analogue Scale,VAS)评分、Borg评分分别为(21.79±3.35)次/min、(112.62±5.27)mmHg、(38.56±3.24)mmHg、(2.56±0.35)分、(2.87±0.36)分,均低于对照组,差异有统计学意义(t=5.638、8.930、2.619、8.010、11.455,P<0.05)。治疗后,观察组氧分压(partial pressure of oxygen,PaO_(2))高于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率为94.34%,略高于对照组的83.02%,但差异无统计学意义(P>0.05)。治疗期间两组并发症总发生率对比,差异无统计学意义(P>0.05)。结论无创正压通气和经鼻高流量氧疗治疗ICU急性心力衰竭患者疗效均较好,但经鼻高流量氧疗治疗改善呼吸循环功能、舒适性及耐受性更好。

Objective To explore the effect of nasal high-flow oxygen therapy on the respiratory and circulatory indicators of patients with acute heart failure in ICU.Methods 106 patients with acute heart failure in ICU admitted to the Second Affiliated Hospital of Xiamen Medical College from January 2021 to December 2022 were conveniently selected in the study.The patients were divided into two groups by random number table method,with 53 cases in each group.Both groups received routine treatment such as cardiotonic,diuretic,antiasthmatic,and vasodilator.The control group received non-invasive positive pressure ventilation,and the observation group received nasal high-flow oxygen therapy.Both groups were observed for 48 h.The clinical indexes of the two groups were compared.Results After treatment,the respiratory rate,mean arterial pressure,pressure of carbon dioxide(PaCO_(2)),Visual Analogue Scale(VAS) score,and Borg score of the observation group were(21.79±3.35) times/min,(112.62±5.27) mmHg,(38.56±3.24) mmHg,(2.56±0.35) points,and(2.87±0.36) points,respectively,which were lower than those of the control group,and the differences were statistically significant(t=5.638,8.930,2.619,8.010,11.455,P<0.05).After treatment,the partial pressure of oxygen(PaO_(2)) in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the total effective rate of the observation group was 94.34%,which was slightly higher than 83.02% of the control group,but the difference was not statistically significant(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups during treatment(P>0.05).Conclusion Both non-invasive positive pressure ventilation and nasal high-flow oxygen therapy have good curative effect on ICU patients with acute heart failure,but nasal high-flow oxygen therapy improves respiratory and circulatory function,comfort and tolerance better.