【摘要】 目的 比较经鼻高流量氧疗（HFNC）与无创机械通气（NIV）在尘肺合并II型呼吸衰竭的应用，探讨HFNC用于尘肺治疗的有效。方法 比较2017年1月至2018年8月期间收治的64例尘肺合并II型呼吸衰竭患者，随机分成2组，观察分别使用HFNC、NIV治疗后的氧合指数、二氧化碳分压（PCO2），呼吸频率（RR）、心率( HR)变化，以及对比两组间舒适度、口干程度和28天生存率。结果两组患者氧合指数均随治疗时间推进逐渐改善（F=55.84，P<0.001），PCO2均随治疗时间推进逐渐减小（F=42.08，P<0.001），且两组氧合指数及PCO2各观察时间点变化无差异（p>0.05）。两组患者气促均可改善（F=417.00，P<0.001），且趋势一致（F=0.84，P>0.05）；两组HR随治疗时长的推进逐渐减小（F=393.71，P<0.001），两组的下降趋势一致。（F=1.32，P>0.05）。HFNC舒适度优于NIV组，HFNC口干程度低于NIV组（p<0.001）。两组28天生存率两组无差异（p>0.05）。结论 HFNC用于尘肺合并II型呼吸衰竭治疗的疗效与NIV类似，且口干程度更低及舒适度更优。

【Abstract】Objective To compare the application of High flow nasal cannula oxygen therapy (HFNC) and non-invasive ventilation (NIV) in pneumoconiosis with hypercapnic respiratory failure, and to explore the effectiveness and safety of HFNC in the treatment of pneumoconiosis.Methods 64 Patients diagnosed with pneumoconiosis with hypercapnic respiratory failure admitted from January 2017 to August 2018，randomly divided into two groups，treatment with HFNC and NIV respectively。The changes of oxygenation index, partial pressure of carbon dioxide (PCO 2), respiratory rate (RR), heart rate (HR), comfort, dry mouth, and 28-day survival rate were compared between the two groups.ResultsAfter treatment, oxygenation index increased （F=55.84，P<0.001）and PCO 2 decreased in both groups（F=42.08，P<0.001），two groups had the same trend of change(p>0.05); RR and HR decreased in both groups(P<0.001), and the trend of change was the same in both groups(p>0.05).HFNC is more comfort than NIV（P<0.001）,and the degree of dry mouth in HFNC group was lower than that in NIV group（P<0.001）. The survival of 28 days was 84.4% in the HFNC group，and 81.3% in the NIV group（p>0.05）. Conclusion For pneumoconiosis with hypercapnic respiratory failure ,HFNC has similar efficacy as NIV,and it has better comfort ,lower dry mouth.

广东省医学科学技术研究基金项目，课题编号A2017600