经鼻高流量氧疗在老年呼吸衰竭病人中的应用

目的比较鼻导管、无创呼吸机、经鼻高流量3种氧疗方式在呼吸衰竭病人中应用的效果。方法纳入26例呼吸衰竭病人以自身为对照,根据随机氧疗顺序,分别采用鼻导管、无创呼吸机、经鼻高流量3种方式氧疗12 h,比较3种方式氧疗前后病人舒适度、痰液黏稠度、氧疗装置移除次数、氧饱和度下降事件次数及动脉血气水平。结果鼻导管氧疗应用后明显降低了病人动脉氧分压(P<0. 05),而高流量吸氧应用后则明显提高了动脉氧分压(P<0. 05)。经鼻高流量氧疗与另2种氧疗方式比较,其舒适度明显增加(P<0. 01),痰液黏稠度明显降低(P<0. 01);鼻导管和高流量氧疗方式与呼吸机比较,氧疗装置移除次数及氧饱和度下降事件明显减少(P<0. 01)。结论经鼻高流量氧疗病人舒适度好,痰液易咳出,病人依从性好,且可提高动脉血氧分压,值得临床推广。

Application of high-flow nasal cannula in the elderly patients with respiratory failure

Objective To compare the effects of oxygen therapies via nasal catheter,high-flow oxygen cannula or non-invasive mechanical ventilation in the patients with respiratory failure. Methods Twenty-six patients with respiratory failure received different oxygen therapies via nasal catheter,high flow oxygen cannula or non-invasive mechanical ventilation for 12 hours according to the randomized oxygen therapy. Patient’s comfort scale,sputum viscosity,removing frequency of oxygen therapy device and oxygen desaturation,and the levels of blood gas indexes were recorded and compared. Results Arterial partial pressure of oxygen decreased significantly after the use of nasal catheter(P<0. 05),but increased significantly by the use of high flow oxygen cannula(P< 0. 05). Patient’s comfort scale was significantly decreased and the sputum viscosity was significantly alleviated by the use of high-flow oxygen cannula(P< 0. 01). The removing frequency of oxygen therapy device and oxygen desaturation were decreased significantly by the use of high-flow oxygen cannula(P< 0. 01). Conclusions Oxygen therapy via high-flow cannula deserves implication for the patients with respiratory failure is comfortable,and help the patients easily expectorate the sputum with good compliance,and increase the arterial oxygen pressure.