目的 分析肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间应用多维度强化护理的效果。方法 纳入2022年12月—2025年1月在河北省胸科医院进行经鼻高流量湿化氧疗的肺结核合并Ⅱ型呼吸衰竭患者294例，随机分为强化护理组（147例，多维度强化护理）、对照组（147例，常规护理），测量比较两组患者在护理前后气道重塑指标、肺功能指标、血气分析指标，进行疗效评估。结果 护理后强化护理组气道壁面积、气道壁厚度低于对照组，气道腔面积高于对照组（P＜0.05）；护理后强化护理组第1秒用力呼气容积、用力肺活量高于对照组（P＜0.05）；护理后强化护理组动脉血氧分压高于对照组，动脉血二氧化碳分压低于对照组（P＜0.05）；强化护理组总有效率高于对照组（P＜0.05）。结论 肺结核合并Ⅱ型呼吸衰竭患者经鼻高流量湿化氧疗期间接受多维度强化护理可改善其气道重塑及肺功能，有利于血气分析指标恢复，应用效果显著。

       Objective To analyze the efficacy of multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy in patients with pulmonary tuberculosis and type Ⅱ respiratory failure．Methods A total of 294 patients with pulmonary tuberculosis and type Ⅱ respiratory failure who received nasal high-flow humidified oxygen therapy at Hebei Chest Hospital between December 2022 and January 2025 were enrolled and randomly divided into an enhanced nursing group（147 patients，receiving multidimensional enhanced nursing）and a control group（147 patients，receiving conventional nursing）．Airway remodeling，pulmonary function，and blood gas analysis were measured and compared between the two groups before and after nursing，and the efficacy was evaluated．Results After nursing，the enhanced nursing group had lower airway wall area and airway wall thickness，and higher airway lumen area than the control group（P＜0.05）．The forced expiratory volume in 1 second and forced vital capacity in the enhanced nursing group were higher than those in the control group（P＜0.05）．The blood oxygen partial pressure（PaO₂）in the enhanced nursing group was higher than that in the control group，and the carbon dioxide partial pressure（PaCO₂）was lower than that in the control group（P＜0.05）．The total effective rate in the enhanced nursing group was higher than that in the control group（P＜0.05）．Conclusions Multidimensional enhanced nursing during nasal high-flow humidified oxygen therapy can improve airway remodeling and lung function in patients with pulmonary tuberculosis and type Ⅱ respiratory failure，and is beneficial for the recovery of blood gas analysis indicators．The application effect is significant．

目的 观察经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期（AECOPD）伴Ⅱ型呼吸衰竭对患者肺功能、血气分析指标的影响。方法 收集2020年3月—2022年3月我院收治的AECOPD伴Ⅱ型呼吸衰竭患者92例,随机分为常规通气组（46例,无创正压通气）、经鼻氧疗组（46例,经鼻高流量氧疗）,测量记录治疗前及治疗后2组患者心率及呼吸频率、血气分析指标、肺功能指标,评估患者舒适度及呼吸困难情况,记录治疗期间并发症。结果 治疗后经鼻氧疗组心率、呼吸频率低于常规通气组（P<0.05）;治疗后经鼻氧疗组二氧化碳分压（PaCO₂）低于常规通气组,动脉血氧分压（PaO₂）高于常规通气组（P<0.05）;治疗后经鼻氧疗组第1秒用力呼出气容积（FEV₁）、用力呼气容积（FVC）高于常规通气组（P<0.05）;治疗后经鼻氧疗组Borg评分低于常规通气组,舒适率高于常规通气组（P<0.05）;经鼻氧疗组并发症发生率低于常规通气组（P<0.05）。结论 给予AECOPD伴Ⅱ型呼吸衰竭患者经鼻高流量氧疗可改善患者肺功能、血气分析指标,促进呼吸困难症状缓解,且可提高患者舒适度,降低并发症发生率。

Objective To observe the effect of nasal high-flow oxygen therapy on pulmonary function and blood gas analysis indexes in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）with type Ⅱ respiratory failure．Methods From March 2020 to March 2022,92 patients with AECOPD complicated with type Ⅱ respiratory failure who were treated in our hospital were enrolled and randomly divided into conventional ventilation group（46 cases,non-invasive positive pressure ventilation）and nasal oxygen therapy group（46 cases,nasal high-flow oxygen therapy）．The heart rate and respiratory rate,blood gas analysis indexes,pulmonary function indexes of the two groups of patients before and after treatment were measured and recorded,the comfort level and dyspnea situation of the patients were evaluated,and the complications during the treatment were recorded．Results After treatment,the heart rate and respiratory rate in the nasal oxygen therapy group were significantly lower than those in the conventional ventilation group（P<0.05）．The partial pressure of carbon dioxide（PaCO₂）in the nasal oxygen therapy group was significantly lower than that in the conventional ventilation group,partial pressure of oxygen（PaO₂）was significantly higher than the conventional ventilation group（P<0.05）．The nasal oxygen therapy group forced expiratory volume in one second,（FEV₁）,forced vital capacity（FVC）were significantly higher than the conventional ventilation group（P<0.05）．The Borg score of nasal oxygen therapy group was significantly lower than the conventional ventilation group,the comfort level was significantly higher than the conventional ventilation group（P<0.05）．The incidence of complications in the nasal oxygen therapy group was significantly lower than that in the conventional ventilation group（P<0.05）．Conclusions Nasal high-flow oxygen therapy for AECOPD patients with type Ⅱ respiratory failure can significantly improve the pulmonary function and blood gas analysis indicators,promote the relief of dyspnea symptoms,improve the comfort level of patients,and reduce the incidence of complications．