高流量鼻导管氧疗在高海拔性低氧血症中的应用

刘晓雪; 杨莉; 钱传云

doi:10.12259/j.issn.2095-610X.S20221216

高流量鼻导管氧疗在高海拔性低氧血症中的应用

doi: 10.12259/j.issn.2095-610X.S20221216

昆明医科大学第一附属医院急救医学部，云南昆明　650032

基金项目: 云南省卫生内设研究机构科研基金资助项目（2018NS0147）

详细信息

作者简介:
刘晓雪（1993～），女，云南大理人，医学硕士，住院医师，主要从事急危重症临床及研究工作

通讯作者:
钱传云，E-mail：qianchuanyun@126.com

中图分类号: R459.6
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出版历程
- 收稿日期: 2022-10-18
- 网络出版日期: 2022-12-06
- 刊出日期: 2022-12-25

Application of High-flow Nasal Cannula Oxygen Therapy in High-altitude Hypoxemia

Dept. of Emergency Medicine，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

摘要

摘要: 目的探讨高流量鼻导管氧疗设备在海拔高于2500 m的地区对人体的氧合的改善。方法征集从中等海拔高度的昆明（海拔约1891 m）快速进入较高海拔的拉萨（海拔约3650 m）的志愿者，在拉萨使用高流量鼻导管氧疗设备吸入空气，比较使用高流量鼻导管氧疗设备前、后志愿者指端脉搏血氧饱和度（SpO₂）、呼吸频率、心率、血压水平。结果在高原地区高流量鼻导管氧疗设备运行未出现故障，运转良好。在应用高流量鼻导管氧疗设备进行空气吸入后，随着吸入气体流量的增加，志愿者SpO₂改善，呼吸频率减低，差异有统计学意义（P < 0.05）。结论高流量鼻导管氧疗设备能改善高海拔地区机体的氧合同时降低呼吸做功，在高海拔性低氧血症的治疗方面存在潜在临床治疗价值。
- 拉萨 /
- 高海拔性低氧血症 /
- 高流量鼻导管氧疗 /
- 脉搏血氧饱和度 /
- 呼吸频率
Abstract: Objective To explore the efficacy of high-flow nasal cannula oxygen therapy on oxygenation in populations at altitudes above 2500 meters. Methods Participants were recruited from medium-altitude Kunming （about 1891 m above sea level） to quickly enter higher altitude Lhasa （about 3650 m above sea level）. Participants inhaled air using high-flow nasal cannula oxygen therapy in Lhasa. The pulse oxygen saturation （SpO₂）, respiratory rate, heart rate and blood pressure were compared before and after the use of high-flow nasal cannula oxygen therapy . Results In high altitude area, the high flow nasal canula oxygen therapy went well and smoothly. After high-flow nasal catheter oxygen therapy, SpO₂ improved and respiratory rate decreased with the increase of inhaled gas flow, the difference was statistically significant （P < 0.05）. After using high-flow nasal cannula oxygen therapy equipment for air inhalation, SpO₂ improved and respiratory rate decreased with the increase of inhaled gas flow, the difference was statistically significant （P < 0.05）. Conclusion High-flow nasal cannula oxygen therapy not only improved participants’ oxygenation, it decreased the effort of breathing, and has potential clinical value in the treatment of high-altitude hypoxemia .
- Lhasa /
- High-altitude hypoxemia /
- High-flow nasal cannula oxygen therapy /
- Pulse oximetry /
- Respiratory rate

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图 1 试验实施流程

Figure 1. Flow of Research

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表 1 不同氧流量下温度和吸入氧浓度比较（$\bar x \pm s $）

Table 1. Comparison of temperature and oxygen concentration under different oxygen flow （$\bar x \pm s $）

指标	治疗前	10 L/min	20 L/min	30 L/min	40 L/min	F	P
温度（℃）	36.70 ± 0.47	36.50 ± 1.36	36.83 ± 0.53	36.87 ± 0.35	36.67 ± 0.99	0.932	0.447
FiO₂（%）	21.00 ± 0.00	22.33 ± 3.21	22.97 ± 2.16	23.10 ± 2.45	22.90 ± 2.23	0.528	0.664

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表 2 治疗前及不同吸氧流量下的氧饱和度、血压、呼吸频率、心率（$\bar x \pm s $）

Table 2. Oxygen saturation，blood pressure，respiratory rate，heart rate before treatment and under different oxygen inhalation flow （$\bar x \pm s $）

指标	治疗前	10 L/min	20 L/min	30 L/min	40 L/min	F	P
收缩压（mmHg）	118.70 ± 15.23	120.90 ± 17.17	118.17 ± 14.22	114.40 ± 16.35	112.90 ± 9.93	1.474	0.213
舒张压（mmHg）	75.87 ± 11.89	74.87 ± 11.77	75.83 ± 8.49	75.23 ± 8.92	77.43 ± 10.35	0.268	0.898
平均动脉压（mmHg）	90.13 ± 11.14	90.23 ± 12.67	89.93 ± 9.99	88.33 ± 10.96	89.27 ± 9.58	0.158	0.959
心率（次/min）	82.47 ± 10.68	85.07 ± 9.86	85.37 ± 10.14	84.77 ± 9.22	81.27 ± 9.68	1.003	0.408
呼吸频率（次/min）	17.43 ± 4.38	14.53 ± 3.60	10.73 ± 3.07	9.20 ± 2.41	8.53 ± 1.83	70.78	< 0.001^*
SpO₂（%）	89.90 ± 3.02	90.73 ± 1.66	91.00 ± 2.51	94.03 ± 2.13	94.97 ± 1.75	71.76	< 0.001^*
^*P < 0.05。

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参考文献(19)

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