【摘要】 目的 评价总结慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)患者应用经鼻高流量氧疗(high-flow nasal cannula, HFNC)的最佳证据。方法 系统检索BMJ Best Practice、UpToDate、国际指南协作网、美国国立指南网、英国国家卫生与临床优化研究所网站、医脉通、JBI循证医学数据库、Cochrane Library、Embase、PubMed、万方、知网数据库以及慢性阻塞性肺疾病全球倡议组织网站、美国呼吸治疗学会网站和欧洲呼吸学会网站关于AECOPD患者应用HFNC的相关文献，包括指南、证据总结、临床决策、专家共识以及系统评价，检索时限为建库至2024年7月25日。采用JBI文献评价标准和证据分级系统，对纳入文献进行质量评价及证据级别评定。结果 共纳入13篇文献，包括2篇指南、1篇临床决策、4篇专家共识以及6篇系统评价，并从适应证及禁忌证、参数设置、注意事项、拔管后应用、雾化应用和成功率预测等6个类别汇总形成20条最佳证据。结论 本研究总结的最佳证据可以为AECOPD患者应用HFNC进行呼吸支持提供借鉴和参考，临床医护人员应谨慎考虑证据的适宜性和可行性，为AECOPD患者制定个性化的HFNC方案。更多还原

【Abstract】 Objective To evaluate and summarize the best evidence for the use of high-flow nasal cannula(HFNC) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Literatures regarding the use of HFNC oxygen therapy in AECOPD patients, which including guidelines, evidence summary, clinical decisions, expert consensus and systematic reviews were systematically searched in BMJ Best Practice, UpToDate, Guidelines International Network, National Guideline Clearinghouse, National Institute for Health and Care Excellence, Medlive, JBI, Cochrane Library, Embase, PubMed, Wanfang, CNKI, Global Initiative for Chronic Obstructive Lung Disease, American Association for Respiratory Care, and European Respiratory Society, and the retrieval time limit was from the establishment of the database to July 25, 2024. The JBI literature evaluation standard and evidence grading system were used to evaluate the quality and evidence level of the included literatures. Results A total of 13 articles were included, including 2 guidelines, 1 clinical decision, 4 expert consensuses, and 6 systematic reviews, and 20 pieces of the best evidences were summarized from 6 aspects including indications and contraindications, parameter settings, precautions, post-extubation uses, nebulization applications, and success rate prediction. Conclusion The best evidence summarized in this study can provide a reference for using HFNC for respiratory support in AECOPD patients, and clinical medical staff should carefully consider the appropriateness and feasibility of the evidence and develop personalized HFNC plan for AECOPD patient.更多还原