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    HFNC在弥漫性肺病合并呼吸衰竭中的治疗作用

    Application of high-flow nasal cannula in the treatment of diffuse lung disease patients with respiratory failure

    • 摘要: 目的 分析经鼻高流量氧疗(high-flow nasal cannula, HFNC)在弥漫性肺病合并呼吸衰竭中的治疗效果。方法 2020年1月—2021年12月在徐州医科大学附属医院呼吸与危重症医学科随机选择90例弥漫性肺病合并呼吸衰竭的患者,根据吸氧方式分为高流量(HFNC)组、常规组和无创呼吸机组(n=30)。分析氧疗后心肺功能相关指标及整体指标,探讨不同吸氧方式对弥漫性肺病合并呼吸衰竭患者的疗效。结果 (1)心肺功能相关指标:治疗15 d后3组患者心率(HR)、呼吸频率(RR)、平均动脉压(MAP)均得到良好恢复,HFNC组患者治疗7 d、15 d后的上述指标恢复程度明显优于其他2组,差异有统计学意义(P<0.05);治疗15 d后,HFNC组患者痰液黏稠度、氧疗装置移除次数较其他2组显著降低(P<0.05);HFNC组和无创呼吸机组患者肺功能、动脉血气分析、氧合指数(PaO2/FiO2)的改善水平明显优于常规组(P<0.05);(2)整体指标:与常规组和无创呼吸机组相比,HFNC组患者的住院时间缩短、临床效果更佳、28 d气管插管率明显降低(P<0.05);HFNC组和常规组患者治疗期间舒适度优于呼吸机组(P<0.05)。结论 弥漫性肺病合并呼吸衰竭患者采用经鼻高流量氧疗效果确切,心肺功能得到更好的改善,住院时间更短,治疗期间更舒适,痰液易排出,建议临床推广使用。

       

      Abstract: Objective To evaluate the therapeutic effect of high flow nasal cannula(HFNC) in the treatment of diffuse lung disease patients with respiratory failure.Methods A total of 90 diffuse lung disease patients with respiratory failure who were admitted to Department of Respiration and Critical Care Medicine, the Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were enrolled. According to the corresponding modes of oxygen inhalation, they were divided into three groups(n=30): a HFNC group, a routine group and a noninvasive ventilation machine group. After oxygen inhalation, their cardiopulmonary functional indexes and overall indexes were analyzed and the curative effect of different oxygen inhalation methods on diffuse lung disease patients with respiratory failure were discussed.Results (1) Related indexes of cardiopulmonary function: After treatment for 15 days, all patients presented improvement in heart rate(HR), respiratory rate(RR) and mean arterial pressure(MAP), but the HFNC group showed remarkably improvement in the above indexes on post-treatment 7 and 15 days, compared the other two groups(P<0.05). After treatment for 15 days, the HFNC group showed significantly reduced sputum viscosity and removal times of oxygen therapy devices, compared with the other two groups(P<0.05). Furthermore, obvious improvement was seen as to pulmonary function, arterial blood gas analysis and oxygenation index(PaO2/FiO2) in the HFNC group and the non-invasive ventilation machine group, compared with the routine group(P < 0.05).(2) Overall indicators: The HFNC group had shorter length of hospitalization stay, better clinical effect and lower rate of 28-day intubation rate than the other two groups(P<0.05). During treatment, patients in the HFNC group and the routine group were more comfortable than the non-invasive ventilation machine group(P<0.05).Conclusions Application of HFNC in diffuse lung disease patients with respiratory failure has definite therapeutic effects. The patients show better recovery of cardiopulmonary function and shorter length of hospitalization stay, and are easier to get rid of the sputum, with more comfort during treatment process.

       

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