经鼻高流量氧疗在急性呼吸衰竭患者急诊救治中的应用

目的探讨经鼻高流量氧疗在急性呼吸衰竭患者急诊救治中的效果。方法选择2018年8～12月因急性呼吸衰竭在本院就诊的120例患者,按随机数字表法分为研究组与对照组,各60例。所有患者入院后均行常规综合性治疗。对照组接受鼻导管供氧治疗,研究组接受经鼻高流量氧疗。治疗期间均密切关注生命体征及血气分析结果,发现病情恶化及时给予气管插管,进行机械通气治疗。分别于氧疗开始后15 min、60 min、120 min统计并比较两组监护仪数据、血气分析数据、呼吸困难评分。比较两组治疗转归情况。结果研究组治疗后的血氧饱和度(SpO_2)、动脉氧分压(PaO_2)值、pH值均明显高于对照组和治疗前,心率(HR)、呼吸频率(RR)均明显低于对照组和治疗前,差异均有统计学意义(P0.05)。研究组治疗后60 min、治疗后120 min的动脉二氧化碳分压(PaCO_2)值均明显低于对照组,差异均有统计学意义(P0.05)。研究组治疗后的Brog评分、舒适度评分均明显低于对照组和治疗前,差异有统计学意义(P0.05)。研究组插管率、病死率均明显低于对照组,住院时间明显短于对照组,差异有统计学意义(P0.05)。结论经鼻高流量氧疗对急性呼吸衰竭患者有较好的治疗效果,应早期应用。

Application of transnasal high-flow oxygen therapy in emergency treatment of patients with acute respiratory failure

Objective To investigate the effect of transnasal high-flow oxygen therapy in emergency treatment of patients with acute respiratory failure.Methods From August to December 2018,120 patients who were admitted in our hospital for acute respiratory failure were seleeted and randomly divided into study group and control group according to random number table method,with 60 cases in each group.All patients underwent routine general treatment after admission.The control group received nasal cannula oxygenation and the study group received transnasal high-flow oxygen therapy.During the treatment,the vital signs and blood gas analysis results were closely observed.The tracheal intubation was given in time for mechanical ventilation treatment when the disease was deteriorated.The data of the two groups of monitors,blood gas analysis data and dyspnea score were counted and compared at 15 min,60 min and 120 min after the start of oxygen therapy.The treatment outcomes of the two groups were compared.Results The blood oxygen saturation(SpO2),arterial oxygen partial pressure(PaO2)and pH value of the study group were significantly higher than those of the control group and before treatment.The heart rate(HR)and respiratory rate(RR)of the study group were significantly lower than those in the control group and before treatment,and the differences were statistically significant(P<0.05).The arterial carbon dioxide partial pressure(PaCO2)value of the study group at 60 min and 120 min after treatment were significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The Brog score and comfort score of the study group were significantly lower than those of the control group and before treatment,and the differences were statistically significant(P<0.05).The intubation rate and mortality of the study group were significantly lower than that the control group,and the hospital stay of the study group was significantly shorter than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Transnasal high-flow oxygen therapy has a good therapeutic effect on patients with acute respiratory failure and should be applied early.