Clinical application of high-flow nasal cannula oxygen therapy in patients with acute respiratory distress syndrome (ARDS)
高流量鼻导管氧疗在急性呼吸窘迫综合征（ARDS）患者中的临床应用

摘要

目的 探讨高流量鼻导管氧疗（HFNC）在急性呼吸窘迫综合征（ARDS）患者中的临床应用效果。方法 选择2023年5月至2024年5月期间我院ICU收治的80例ARDS患者，按随机分组法分为对照组和观察组，每组各40例。对照组采用传统文丘里面罩吸氧治疗，观察组采用高流量鼻导管氧疗。分别记录两组患者的血气及氧合指标（PaO2、PaCO2、SaO2、PaO2/FiO2）、血流动力学参数（MAP、MPAP、CVP、CI）、辅助通气时间、ICU住院时间及并发症发生情况，并进行统计学分析。结果 治疗3天后，观察组的PaO2和PaO2/FiO2显著高于对照组（P<0.05），两组PaCO2差异无统计学意义（P>0.05）。观察组的辅助通气时间和ICU住院时间显著短于对照组（P<0.05）。再插管率和28天病死率在观察组均低于对照组，并发症发生率也显著较低（P<0.05）。结论 高流量鼻导管氧疗相较于传统文丘里面罩氧疗，在改善ARDS患者的氧合状态、缩短辅助通气时间及ICU住院时间、降低再插管率及并发症发生率方面效果更好，具有重要的临床应用价值。

Abstract

Objective To explore the clinical application effect of high-flow nasal cannula oxygen therapy (HFNC) in patients with acute respiratory distress syndrome (ARDS).
Methods 80 ARDS patients admitted to the ICU of our hospital from May 2023 to May 2024 were selected and divided into a control group and an observation group according to the random grouping method, with 40 cases in each group. The control group was treated with traditional Venturi mask oxygen therapy, and the observation group was treated with high-flow nasal cannula oxygen therapy. The blood gas and oxygenation indicators (PaO2, PaCO2, SaO2, PaO2/FiO2), hemodynamic parameters (MAP, MPAP, CVP, CI), assisted ventilation time, ICU hospitalization time and the occurrence of complications of the two groups of patients were recorded respectively, and conduct statistical analysis.
Results After 3 days of treatment, the PaO2 and PaO2/FiO2 of the observation group were significantly higher than those of the control group (P<0.05), and the difference in PaCO2 between the two groups was not statistically significant (P>0.05). The assisted ventilation time and ICU hospitalization time of the observation group were significantly shorter than those of the control group (P<0.05). The reintubation rate and 28-day mortality rate in the observation group were lower than those in the control group, and the incidence of complications was also significantly lower (P<0.05).
Conclusion   High-flow nasal cannula oxygen therapy is more effective than traditional venturi mask oxygen therapy in improving the oxygenation status of ARDS patients, shortening assisted ventilation time and ICU stay, and reducing reintubation rate and complication rate. It has important clinical application value.