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目的:探索经鼻高流量氧疗（HFNC）在慢性阻塞性肺疾病急性加重期患者中的临床应用价值。方法:以2017年6月至2018年6月济宁医学院附属湖西医院（单县中心医院）收治的61例慢性阻塞性肺疾病急性加重期患者为临床研究对象，使用随机数字表法将患者分为对照组和治疗组，对照组31例，治疗组30例，两组患者均常规给予抗感染、抗炎、祛痰、解痉、平喘、抗凝、营养支持等治疗。对照组给予常规低流量氧疗，治疗组给予经鼻高流量氧疗。观察两组患者治疗开始前及治疗后12、24、48和72 h各时间点动脉血氧分压（PaOn 2）、动脉血二氧化碳分压（PaCOn 2）、肺动脉收缩压（PSAP）、右室压力最大上升速率（dp/dt）的变化，以及7 d内无创机械通气及有创机械通气的应用率情况。n 结果:两组患者治疗前PaOn 2、PaCOn 2、PSAP及dp/dt比较差异均无统计学意义（n P>0.05）。治疗组较对照组，治疗后各时间点PaOn 2均降低[（54.37 ± 5.39）mmHg（1 mmHg=0.133 kPa）比（57.77 ± 6.06）mmHg、（61.87 ± 5.20）mmHg比（65.03 ± 4.91）mmHg、（66.93 ± 6.59）mmHg比（72.58 ± 7.13）mmHg、（70.20 ± 8.18）mmHg比（75.55 ± 7.37）mmHg，n P<0.05]；PaCOn 2均降低[（57.97 ± 6.18）mmHg比（61.84 ± 6.20）mmHg、（51.27 ± 4.53）mmHg比（55.77 ± 5.87）mmHg、（48.57 ± 5.37）mmHg比（51.55 ± 4.62）mmHg、（44.70 ± 5.40）mmHg比（47.68 ± 5.86）mmHg，n P<0.05]；PSAP均降低[（50.80 ± 6.94）mmHg比（54.55 ± 6.58）mmHg、（48.70 ± 6.22）mmHg比（52.55 ± 6.91）mmHg、（45.33 ± 7.51）mmHg比（49.19 ± 6.40）mmHg、（41.23 ± 9.22）mmHg比（45.94 ± 7.35）mmHg，n P<0.05]；dp/dt均增高[（403.77 ± 109.43）mmHg/s比（345.39 ± 112.50）mmHg/s、（429.83 ± 102.56）mmHg/s比（369.77 ± 110.55）mmHg/s、（483.43 ± 105.20）mmHg/s比（426.48 ± 107.27）mmHg/s、（532.43 ± 107.01）mmHg/s比（473.74 ± 105.00）mmHg/s，n P<0.05]；两组对比治疗组7 d内无创/有创机械通气的应用率更低（n P<0.05）。n 结论:HFNC对慢性阻塞性肺疾病Ⅱ级的患者有更好的临床疗效，有助于心肺功能的改善。“,”Objective:To explore the clinical value of nasal high flow oxygen therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods:From June 2017 to June 2018, 61 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) admitted to the Huxi Hospital (Shanxian Central Hospital) Affiliated to Jining Medical College were taken as the clinical research objects. The patients were divided into control group and treatment group by using the random number table method with 31 patients in control group and 30 patients in treatment group. They all treated with anti-infection, anti-inflammation, expectoration, spasmolysis, asthma relief, anticoagulation and nutritional support. The control group was given conventional low flow oxygen therapy, while the treatment group was given nasal high flow oxygen therapy. The changes of partial pressure of oxygen (PaOn 2), partial pressure of carbon dioxide (PaCOn 2), pulmonary artery systolic pressure (PSAP), right ventricular pressure maximum rise rate (dp/dt) and the application rate of non-invasive and invasive mechanical ventilation within 7 d were observed before and 12, 24, 48 and 72 h after treatment.n Results:Before treatment, PaOn 2, PaCOn 2, PSAP and dp/dt of patients in the two groups showed no statistical difference, indicating comparability between groups. Compared with the control group, the PaOn 2 in the treatment group decreased at all time points after treatment [(54.37 ± 5.39) mmHg (1 mmHg=0.133 kPa) vs. (57.77 ± 6.06) mmHg, (61.87 ± 5.20) mmHg vs. (65.03 ± 4.91) mmHg, (66.93 ± 6.59) mmHg vs. (72.58 ± 7.13) mmHg, (70.20 ± 8.18) mmHg vs. (75.55 ± 7.37) mmHg, n P<0.05]. PaCOn 2 decreased [(57.97 ± 6.18) mmHg vs. (61.84 ± 6.20) mmHg, (51.27 ± 4.53) mmHg vs. (55.77 ± 5.87) mmHg, (48.57 ± 5.37) mmHg vs. (51.55 ± 4.62) mmHg, (44.70 ± 5.40) mmHg vs. (47.68 ± 5.86) mmHg, n P<0.05]. PSAP all decreased [(50.80 ± 6.94) mmHg vs. (54.55 ± 6.58) mmHg, (48.70 ± 6.22) mmHg vs. (52.55 ± 6.91) mmHg, (45.33 ± 7.51) mmHg vs. (49.19 ± 6.40) mmHg, (41.23 ± 9.22) mmHg vs. (45.94 ± 7.35) mmHg,n P<0.05]. Dp/dt all increased [(403.77 ± 109.43) mmHg/s vs. (345.39 ± 112.50) mmHg/s, (429.83 ± 102.56) mmHg/s vs. (369.77 ± 110.55) mmHg/s, (483.43 ± 105.20) mmHg/s vs. (426.48 ± 107.27) mmHg/s, (532.43 ± 107.01) mmHg/s vs. (473.74 ± 105.00) mmHg/s.n P<0.05]. The application rate of non-invasive/invasive mechanical ventilation in the treatment group was lower than that in the control group within treated for 7 d (n P<0.05).n Conclusions:Transnasal high-flow oxygen therapy has a better clinical effect on patients with chronic obstructive pulmonary disease and is helpful to improve the right heart function.