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目的:探讨经鼻高流量湿化氧疗优化预氧合在危重症患者气管插管前应用的临床研究。方法:选择2018年6月至2019年6月浙江省义乌市中心医院需紧急气管插管的危重症患者100例作为研究对象，按照随机数字表法分为观察组50例与对照组50例。两组患者均持续监测生命体征，取患者仰卧位后，以传统手法开放气道，清除口腔和呼吸道分泌物。对照组患者采用球囊面罩加压给氧，观察组患者采用经鼻高流量湿化氧疗。比较两组达到目标预氧合所需时间，预氧合前、预氧合后和插管后即刻血气分析和血氧饱和度（SpOn 2）变化，腹胀发生情况。n 结果:观察组达到目标预氧合所需时间快于对照组[（4.34 ± 0.56）min比（7.62 ± 1.43）min]（n P<0.05）。观察组动脉血氧分压（PaOn 2）预氧合后和插管后即刻高于对照组[（67.25 ± 2.34）mmHg（1 mmHg=0.133 kPa）比（61.87 ± 2.65）mmHg、（62.46 ± 3.51）mmHg比（56.32 ± 3.98）mmHg]，而动脉二氧化碳分压（PaCOn 2）预氧合后和插管后即刻低于对照组[（38.78 ± 2.68）mmHg比（43.12 ± 2.95）mmHg、（42.57 ± 2.65）mmHg比（49.46 ± 3.43）mmHg]（n P<0.05）。观察组SpOn 2预氧合后和插管后即刻高于对照组（0.97 ± 0.03比0.92 ± 0.03、0.92 ± 0.03比0.88 ± 0.05）（n P<0.05）。观察组腹胀发生率低于对照组[4.00%（2/50）比24.00%（12/50）]（n P<0.05）。n 结论:经鼻高流量湿化氧疗优化预氧合在危重症患者气管插管前应用效果良好，可提高患者血氧水平，减少并发症。“,”Objective:To investigate the clinical application of optimized preoxygenation with nasal high flow humidification oxygen therapy before tracheal intubation in critically ill patients.Methods:The100 critically ill patients who needed emergency tracheal intubation in ZhejiangYiwu Central Hospital from June 2018 to June 2019 were selected as the research objects. According to the random number table method, they were randomly divided into observation group (50 cases) and control group (50 cases). The vital signs were continuously monitored in both groups. After the supine position was taken, the airway was opened by traditional methods to remove oral and respiratory secretions. The patients in the control group were given pressure oxygen by balloon mask, while the patients in the observation group were given pre-oxygenation by nasal high flow humidification oxygen therapy. The time required to achieve the goal of pre-oxygenation, blood gas analysis, SpOn 2 changes and abdominal distension before and after pre-oxygenation and after intubation were compared between the two groups.n Results:In observation group, time required to reach the target preoxygenation was faster than control group: (4.34 ± 0.56) min vs. (7.62 ± 1.43) min (n P<0.05). In the observation group, PaOn 2 preoxygenation and immediately after intubation were higher than those in control group: (67.25 ± 2.34) mmHg (1 mmHg=0.133 kPa) vs. (61.87 ± 2.65) mmHg, (62.46 ± 3.51) mmHg vs. (56.32 ± 3.98) mmHg; while those after PaCOn 2 preoxygenation and immediately after intubationwere lower than those in control group: (38.78 ± 2.68) mmHg vs. (43.12 ± 2.95) mmHg, (42.57 ± 2.65) mmHg vs. (49.46 ± 3.43) mmHg, the differences were statistically significant (n P<0.05). In observation group, SpOn 2 preoxygenation and immediately after intubation were higher than those control group: 0.97 ± 0.03 vs. 0.92 ± 0.03, 0.92 ± 0.03 vs. 0.88 ± 0.05, the differences were statistically significant (n P<0.05). In observation group, the incidence of abdominal distension was lower than that in control group: 4.00%(2/50) vs. 24.00% (12/50), the difference was statistically significant (n P<0.05).n Conclusions:Optimized preoxygenation with nasal high flow humidification oxygen therapy has a good effect before tracheal intubation in critically ill patients. It can improve the blood oxygen level and reduce complications.