Clinical observation of humidified high-flow nasal cannula oxygen therapy (HHFNC) combined with precision nursing in severe chronic obstructive pulmonary disease patients
加温湿化高流量鼻导管通气（HHFNC）联合精细化护理在重症慢阻肺患者中的临床观察

摘要

目的 本文分析经鼻高流量湿化氧疗，结合精细化护理方案，对重症慢阻肺患者临床改善的作用。方法 本文回顾性选择2025年1月至2026年1月期间本院重症医学科收治的60例重症慢阻肺急性加重合并Ⅱ型呼吸衰竭患者作为研究对象，通过随机数字表法将其平均分为对照组和观察组，每组各30例。其中对照组进行常规无创通气、基础护理，观察组应用经鼻高流量湿化氧疗并配合精细化护理干预。本文通过动态监测两组患者在干预前后的血气分析结果、肺呼吸功能参数，来对不同方案的临床应用效果进行评价。结果 治疗72h后，观察组动脉血氧分压（PaO2）、氧合指数（PaO2/FiO2）显著高于对照组，动脉血二氧化碳分压（PaCO2）显著低于对照组（P<0.05）；观察组呼吸频率、心率显著低于对照组，舒适度评分显著高于对照组（P<0.05）。结论 对重症慢阻肺患者联合使用湿化高流量鼻导管通气（Humidified High-Flow Nasal Cannula, HHFNC）和精细化护理干预，可以纠正血气失衡并能提高呼吸功能，这在县级医院重症医学科中具有明显且重要的临床应用和推广价值。

Abstract

Objective This study evaluates the clinical efficacy of high-flow nasal cannula oxygen therapy combined with a refined nursing protocol in improving outcomes for patients with severe chronic obstructive pulmonary disease (COPD) exacerbation and type II respiratory failure.
Methods A retrospective study was conducted on 60 patients with severe COPD exacerbation and type II respiratory failure admitted to the intensive care unit (ICU) of our hospital between January 2025 and January 2026. The patients were randomly divided into a control group and an observation group (30 cases each) using a random number table. The control group received conventional non-invasive ventilation and basic nursing care, while the observation group received high-flow nasal cannula oxygen therapy combined with refined nursing interventions. The clinical outcomes of the two approaches were assessed by dynamically monitoring blood gas analysis results and pulmonary respiratory function parameters before and after intervention.
Results After 72 hours of treatment, the observation group exhibited significantly higher arterial oxygen partial pressure (PaO2) and oxygenation index (PaO2/FiO2), as well as significantly lower arterial carbon dioxide partial pressure (PaCO2), compared to the control group (P<0.05). Additionally, the observation group demonstrated significantly lower respiratory rate and heart rate, along with higher comfort scores, than the control group (P<0.05).
Conclusion   The combined use of high-flow nasal cannula oxygen therapy (HHFNC) and refined nursing interventions can correct blood gas imbalances and improve respiratory function in patients with severe COPD. This approach holds significant and practical clinical value for intensive care units in county-level hospitals.