经鼻高流量氧疗及无创正压通气治疗肺水肿患者的临床效果

doi:10.3969/j.issn.1671-7171.2025.04.011

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摘要【目的】探讨经鼻高流量氧疗(HFNC)及无创正压通气治疗肺水肿患者的临床效果。【方法】回顾性分析2021年9月至2024年9月在本院诊治的166例肺水肿患者的临床资料,其中接受无创正压通气治疗86例(对照组),接受HFNC治疗80例(观察组),进一步采用倾向性评分的方法分别于观察组与对照组中各选取65例作为研究对象。比较两组症状改善情况及治疗前、治疗2 d后动脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、血氧饱和度(SpO₂)、平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、呼吸流量峰值(PEF)、第一秒用力呼气容积(FEV₁)、FEV₁/用力肺活量(FEV₁/FVC)。统计两组治疗期间并发症发生情况及28 d病死率。【结果】观察组7 d内气管插管率低于对照组,无创通气时间、双肺啰音消失时间、肺水肿完全消失时间、住院时间均显著少于对照组(P<0.05)。治疗后,观察组PaO₂、SpO₂、MAP、PEF、FEV₁、FEV₁/FVC显著高于对照组(P<0.05),PaCO₂、HR、RR显著低于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05);观察组28 d病死率显著低于对照组(P<0.05)。【结论】HFNC治疗肺水肿可显著改善患者临床症状,降低气管插管率及28 d病死率,且安全性较高。

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	王静
	邬超
	刘冬

关键词 ：肺水肿, 呼吸人工, 氧吸入疗法, 治疗结果

Abstract：【Objective】Objective To investigate the clinical effects of high-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)in patients with pulmonary edema.【Methods】The clinical data of 166 patients with pulmonary edema treated in our hospital from September 2021 to September 2024 were retrospectively analyzed. Among them,86 patients received NIPPV(the control group)and 80 patients received HFNC(the observation group).Further,65 cases were selected from each group using propensity score matching as the study subjects. The improvement of symptoms and arterial oxygen partial pressure(PaO₂),arterial carbon dioxide partial pressure(PaCO₂),oxygen saturation(SpO₂),mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),peak expiratory flow(PEF),forced expiratory volume in the first second(FEV₁),and the ratio of FEV₁ to forced vital capacity(FEV₁/FVC)before and 2 days after treatment were compared between the two groups. The incidence of complications during treatment and 28-day mortality were also statistically analyzed. 【Results】The tracheal intubation rate within 7 days in the observation group was lower than that in the control group. The duration of non-invasive ventilation, the time for disappearance of bilateral lung rales, the time for complete disappearance of pulmonary edema, and the hospital stay were all significantly shorter in the observation group than in the control group(P<0.05).After treatment,PaO₂,SpO₂,MAP,PEF,FEV₁,and FEV₁/FVC in the observation group were significantly higher than those in the control group(P<0.05),while PaCO₂, HR, and RR were significantly lower(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05);however,the 28-day mortality in the observation group was significantly lower than that in the control group(P<0.05). 【Conclusion】 HFNC can significantly improve clinical symptoms in patients with pulmonary edema, reduce the tracheal intubation rate and 28-day mortality, and has high safety.

Key words： Pulmonary Edema Respiration Artificial Oxygen Inhalation Therapy Treatment Outcome

收稿日期: 2025-03-06

中图分类号:

R541.63

引用本文:

王静, 邬超, 刘冬. 经鼻高流量氧疗及无创正压通气治疗肺水肿患者的临床效果[J]. 医学临床研究, 2025, 42(4): 597-600.
WANG Jing, WU Chao, LIU Dong. Clinical Effects of High-Flow Nasal Cannula Oxygen Therapy and Non-Invasive Positive Pressure Ventilation in Patients with Pulmonary Edema. JOURNAL OF CLINICAL RESEARCH, 2025, 42(4): 597-600.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.04.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I4/597

[1] 刘宁宁,王炜璐,李绚璇,等. 感染性休克患者应用重症超声联合脉搏指示连续心排血量监测指导液体复苏的效果[J].中华医院感染学杂志,2024,34(21):3216-3220.
[2] 范勇,史玉玲,刘杰. 高原肺水肿发病机制及防治研究进展[J].河南中医,2023,43(9):1435-1444.
[3] 石建国,鲜文,陈想贵,等. 机械通气缓解高原肺水肿患者舌下微循环和改善右心功能[J].基础医学与临床,2021,41(8):1151-1155.
[4] 徐亚琴, 蔡珣, 王圆圆. 经鼻高流量湿化氧疗与无创正压通气治疗AECOPD并发呼吸衰竭对血气分析指标及氧化应激的影响[J].海军医学杂志, 2022,43(4):380-384.
[5] 何小军, 王勇, 郭伟. 日本呼吸病学协会无创正压通气指南(第二次修订版)[J].中华急诊医学杂志, 2017, 26(7):735-738.
[6] 丁勇, 王飞, 徐婷婷,等. 脑出血评分对原发性脑出血患者发生卒中相关性肺炎的预测价值[J].中国脑血管病杂志, 2018, 15(2):73-76.
[7] 次彩哲,邰炜彦,耿小勇,等. 高流量氧疗与常规氧疗治疗急性心源性肺水肿的应用效果[J].河北医药,2024,46(5):688-692.
[8] 梁哲,李登高,卓玛,等. 无创呼吸机治疗急性高原反应肺水肿的疗效及对患者肺功能康复的影响观察[J].贵州医药,2022,46(1):40-41.
[9] 陶金好. 无创通气支持在儿童急性呼吸窘迫综合征中的应用[J].中国当代儿科杂志, 2018, 20(9):713-716.
[10] LI J, TU M L, YANG L, et al. Worldwide clinical practice of high-flow nasal cannula and concomitant aerosol therapy in the adult ICU setting[J].Respir Care,2021, 66(9):1416-1424.
[11] 高瑞丽, 李彦波, 费月海. 经鼻高流量吸氧装置在高龄急性呼吸衰竭患者中应用[J].临床军医杂志, 2018, 46(3):305-306.
[12] 张帅, 刘满仙, 刘健斌. 经鼻高流量湿化氧疗治疗ACPE的疗效及对患者血气分析指标的影响[J].海南医学, 2022, 33(1):90-92.
[13] 左利平, 俞树青, 刘洪艳,等. 经鼻高流量氧疗在急性呼吸衰竭患者急诊救治中的应用[J].中国现代医生, 2019, 57(17):4-7.
[14] 苏利,吴艳.前列地尔联合HFNC对神经重症拔管患者血气指标、肺功能及炎症水平的影响[J].川北医学院学报, 2022, 37(12):1618-1621.
[15] 邓希, 于海容, 权帅,等. 经鼻高流量氧疗对Ⅱ型急性呼吸衰竭患者的疗效观察[J].国际呼吸杂志, 2020, 40(24):1868-1873.