目的:探讨高流量经鼻导管湿化氧疗在肺炎并Ⅰ型呼吸衰竭机械通气撤机序贯治疗中的疗效。方法:选取2023年1月-2024年12月收治的 70例肺炎并Ⅰ型呼吸衰竭患者分为实验组和对照组,均给予机械通气治疗,实验组采用高流量经鼻导管湿化氧疗,对照组采用无创正压通气治疗,比较两组患者临床疗效,治疗前、治疗12、24、48 h后血气分析指标、痰液性状,治疗前、治疗3 d后炎症指标水平,序贯治疗时间、总住院时间及再次插管机械通气率。结果:实验组临床疗效总有效率高于对照组(P＜0.05)。两组治疗前、治疗12、24、48 h后PaO₂、PaCO₂、SaO₂水平差异无统计学意义(P＞0.05)。两组治疗前CRP、PCT水平无差异(P＞0.05),治疗3 d后实验组CRP、PCT低于对照组(P＜0.05),治疗前两组患者痰液性状无显著性差异(P＞0.05),治疗12、24、48 h后实验组患者痰液性状Ⅰ度均优于对照组(P＜0.05),实验组患者序贯治疗时间及总住院时间均低于对照组(P＜0.05)。结论:高流量经鼻导管湿化氧疗应用于肺炎合并Ⅰ型呼吸衰竭机械通气撤机后患者可提高临床疗效,稀释痰液,改善氧合,降低炎症反应,提高患者耐受程度,降低因不耐受再次插管机械通气的风险,缩短治疗时间,促进其康复,值得应用。

Objective: To investigate and analyze the efficacy of high-flow nasal cannula oxygen therapy in the sequential treatment of mechanical ventilation weaning for pneumonia complicated with type I respiratory failure. Methods: A total of 70 patients with pneumonia and type I respiratory failure admitted from January 2023 to December 2024 were divided into experimental group and control group. All patients were treated with mechanical ventilation. The experimental group was treated with high-flow nasal cannula oxygen therapy, and the control group was treated with non-invasive positive pressure ventilation. The clinical efficacy, blood gas analysis indexes (before treatment, 12, 24 and 48 hours after treatment) and sputum traits, inflammation index levels (before treatment and 3 days after treatment), sequential treatment time, total hospitalization time and reintubation mechanical ventilation rate were compared between the two groups. Results: The total effective rate of clinical efficacy in the experimental group was higher than that in the control group (P＜0.05). There were no statistically significant differences in PaO₂, PaCO₂, and SaO₂ levels between the two groups before treatment and at 12, 24, and 48 hours after treatment (P＞0.05). There was no significant difference in PaO₂, PaCO₂ and SaO₂ levels between the two groups before treatment and 12,24 and 48 hours after treatment (P＞0.05). There was no difference in CRP and PCT levels between the two groups before treatment (P＞0.05). After 3 days of treatment, CRP and PCT in the experimental group were lower than those in the control group (P＜0.05). There was no significant difference in sputum traits between the two groups before treatment (P＞0.05). After 12, 24 and 48 hours of treatment, the sputum traits I of the experimental group were better than those of the control group (P＜0.05). The sequential treatment time and total hospitalization time of the experimental group were lower than those of the control group (P＜0.05). Conclusion: High-flow nasal cannula oxygen therapy can improve the clinical efficacy of patients with pneumonia complicated with type I respiratory failure after mechanical ventilation weaning, dilute sputum, improve oxygenation, reduce inflammation, improve patient tolerance, reduce the risk of re-intubation mechanical ventilation due to intolerance, shorten the treatment time, and promote its rehabilitation. It is worthy of application.