作者：蒋倩1 ，曾安娜2 ，刘茜巍3

单位：

1.830000新疆维吾尔自治区乌鲁木齐市，新疆医科大学第一附属医院呼吸二科　2.830000新疆维吾尔自治 区乌鲁木齐市，新疆医科大学第一附属医院综合外科/特需外科　3.830000新疆维吾尔自治区乌鲁木齐市，新疆医科大 学第一附属医院肾病一科

Units：

1.Department of Respiratory, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China 2.Department of Comprehensive Surgery/Specialty Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China 3.Department of Nephrology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China

关键词：

　感染；肺部感染；经鼻高流量湿化氧疗；鼻导管氧疗

Keywords：

Infections; Pulmonary infection; High-flow nasal cannula oxygen therapy; Nasal cannula oxygenation

CLC：

R 63

DOI：

10.12114/j.issn.1008-5971.2024.00.117

Funds：

省部共建中亚高发病成因与防治国家重点实验室开放课题项目（SKL-HIDCA-2023-23）

摘要：

目的　比较经鼻高流量湿化氧疗（HFNC）与鼻导管氧疗（NCO）在肺部感染患者中的应用效果。方 法　回顾性选取2020年8月—2022年8月新疆医科大学第一附属医院呼吸二科收治的肺部感染患者98例为研究对象。 采用随机数字表法将其分为HFNC组和NCO组，每组49例。除氧疗方式外两组患者接受相同的干预，其中HFNC组患 者选择HFNC，NCO组患者选择NCO，两组患者均连续干预7 d。比较两组临床疗效，干预前后血气分析指标〔血氧饱 和度（SpO2）、动脉血氧分压（PaO2）〕、炎症指标〔C反应蛋白（CRP）、白细胞计数（WBC）〕，体温恢复正常 时间、咳嗽症状消失时间，干预后肺功能指标〔用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC〕， 干预期间并发症发生率。结果　HFNC组临床疗效优于NCO组（P＜0.05）。干预后，HFNC组SpO2、PaO2高于NCO组 （P＜0.05）；NCO组、HFNC组干预后SpO2、PaO2分别高于本组干预前（P＜0.05）。干预后，HFNC组CRP、WBC低 于NCO组（P＜0.05）；NCO组、HFNC组干预后CRP、WBC分别低于本组干预前（P＜0.05）。HFNC组体温恢复正常 时间、咳嗽症状消失时间短于NCO组，干预后FVC、FEV1、FEV1/FVC高于NCO组（P＜0.05）。HFNC组干预期间并发 症发生率低于NCO组（P＜0.05）。结论　与NCO相比，HFNC可以更有效地提高肺部感染患者的临床疗效，改善氧合 情况，减轻机体炎症反应，缩短治疗时间，提高肺功能，且安全性更好。

Abstract：

Objective To compare the application effect of high-flow nasal cannula oxygen therapy (HFNC) and nasal cannula oxygenation (NCO) in patients with pulmonary infection. Methods Ninety-eight patients with pulmonary infection admitted to Department of Respiratory, the First Affiliated Hospital of Xinjiang Medical University from August 2020 to August 2022 were retrospectively selected as the study objects. They were divided into HFNC group and NCO group with 49 cases in each group by random number table method. In addition to oxygen therapy, patients in both groups received the same intervention, and patients in HFNC group chose HFNC and patients in NCO group chose NCO, and both groups received continuous intervention for 7 days. The clinical efficacy, blood gas analysis indexes [oxygen saturation of blood (SpO2) , partial arterial oxygen pressure (PaO2) ] and inflammatory indexes [C-reactive protein (CRP) , white blood cell count (WBC) ] before and after intervention, the temperature recovery time, disappearance time of cough symptoms, the pulmonary function indexes [forced vital capacity (FVC) , forced expiratory volume in one second (FEV 1) , FEV 1/FVC] after intervention, the incidence of complications during intervention were compared between the two groups. Results The clinical effect of HFNC group was better than that of NCO group ( P < 0.05) . After intervention, SpO2 and PaO2 in HFNC group were higher than those in NCO group (P < 0.05) . In NCO group and HFNC group, SpO2 and PaO2 after intervention were higher than those before intervention, respectively (P < 0.05) . After intervention, CRP and WBC in HFNC group were lower than those in NCO group (P < 0.05) . In NCO group and HFNC group, CRP and WBC after intervention were lower than those before intervention, respectively (P < 0.05) . The temperature recovery time, disappearance time of cough symptoms in HFNC group were shorter than those in NCO group, and the FVC, FEV1 and FEV1/FVC after intervention in NCO group were higher than those in NCO group ( P < 0.05) . The incidence of complications during intervention in HFNC group was lower than that in NCO group (P < 0.05) . Conclusion Compared with NCO, HFNC can more effectively improve the clinical efficacy of patients with pulmonary infection, improve oxygenation, reduce inflammation, shorten treatment time, improve lung function, and has better safety.

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