摘要目的 探讨经鼻高流量氧疗（HFNO）序贯治疗急性呼吸衰竭患者的临床效果。方法 回顾性分析2019年9月至2020年12月上饶市立医院呼吸重症监护病房（RICU）收治的60 例急性呼吸衰竭患者的临床资料，根据治疗方式不同将其分为对照组（n=30）和试验组（n=30）。对照组拔管后采用无创呼吸机辅助通气，试验组拔管后采用HFNO 序贯治疗。比较两组治疗前、治疗2 h 后的生命指征，治疗前、治疗1、3 d 后的血气指标，以及两组的治疗情况（二次插管、拔管后呼吸衰竭、RICU 停留时间）。结果 两组治疗2 h 后的呼吸频率（RR）低于本组治疗前，但试验组治疗2 h 后的RR 高于对照组，差异有统计学意义（P＜0.05）；两组治疗后1、3 d 的血氧分压（PaO2）、血氧饱和度（SaO2）均高于本组治疗前，且试验组治疗后1、3 d 的PaO2、SaO2 高于对照组，差异有统计学意义（P＜0.05）；试验组的RICU 停留时间短于对照组，差异有统计学意义（P＜0.05）。结论 HFNO 应用于呼吸衰竭拔管后序贯治疗可改善患者血气指标。
Abstract：Objective To investigate the clinical effect of high-flow nasal oxygen (HFNO) therapy in sequential treatment of patients with acute respiratory failure.Methods Clinical data of 60 patients with acute respiratory failure who were admitted to the Respiratory Intensive Care Unit (RICU) of Shangrao Municipal Hospital from September 2019 to December 2020 were retrospectively analyzed.The patients were divided into control group (n=30) and test group (n=30) according to the treatment method.The control group underwent non-invasive ventilator-assisted ventilation after extubation,and the test group underwent sequential HFNO therapy after extubation.Vital signs before treatment and 2 h after treatment,blood gas indicators before treatment and 1 and 3 d after treatment,and treatment conditions (secondary intubation,post-extubation respiratory failure,length of RICU stay) were compared between the two groups.Results After 2 h of treatment,the respiratory rate (RR) in two groups was lower than that before treatment,but the RR of the test group was higher than that of the control group,with a statistically significant difference (P＜0.05).The partial pressure of blood oxygen (PaO2) and blood oxygen saturation (SaO2) in two groups at 1 and 3 d after treatment were higher than those before treatment,and the PaO2 and SaO2 in the test group were higher than those in the control group,with statistically significant differences (P＜0.05).The length of RICU stay of test group was shorter than that of the control group,and the difference was statistically significant (P＜0.05).Conclusion Applying sequential HFNO therapy to patients with acute respiratory failure after extubation can improve blood gas indicators.
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