Abstract: Objective: To apply the best evidence for pulmonary rehabilitation training for patients receiving high -flow nasal cannula oxygen therapy in health service and evaluate the effectiveness. Methods: An evidence-based team was formed guided by the i-PARIHS framework, and the evidence was converted and applied according to five steps including evidence acquisition, baseline review, obstacle analysis, evidence application, and effect evaluation. Using cluster sampling method, 45 nurses and 120 patients with chronic respiratory diseases who applied HFNC were included. Thepromotion and obstacle factors of the review indicators with a clinical implementation rate of<90% were evaluated and action strategies were developed. Clinical standard implementation rate of nurses and the 6-minute walking distance of patients before and after implementing interventions based on comparative evidence were compared. Results: Thirteen best evidences were included finally and 14 review indicators were developed. The implementation rate of the review indicators to improve the best evidence-based practice of pulmonary rehabilitation training was more than 90%, and the implementation rate of 14 indicators was improved after intervention. In addition, the 6-min walking distance of patients in the evidence application stage was better than that in the baseline review stage (P<0.05). Conclusion: Through the evidence -based practice of pulmonary rehabilitation based on i-PARIHS framework, the effect of pulmonary rehabilitation training on HFNC patients was effectively improved and the activity endurance of patients was enhanced.

Key words: I-PARIHS model, High flow nasal cannula oxygen therapy, Pulmonary rehabilitation training

摘要： 目的：总结经鼻高流量氧疗（High-Flow Nasal Cannula Oxygen Therapy，HFNC）患者肺康复训练的最佳证据，并应用于临床，评价其应用效果。方法：组建循证团队，以整合式健康服务领域研究成果应用的行动促进（Integrated Promoting Action on Research Implementation in Health Services，i-PARIHS）框架为理论指导，按照证据获取、基线审查、障碍分析、证据应用、效果评价 5 个步骤进行证据的转换应用。采用整群抽样法，选取 45 例护士及 120 例慢性呼吸道疾病中应用 HFNC 的患者作为调查对象，对临床执行率<90%的审查指标的促进和障碍因素进行评估并制定行动策略。比较证据实施前后护士对临床标准的执行率及患者的 6 min 步行距离。结果：最终纳入 13 条最佳证据，制定 14 条审查指标。干预后 14 条审查指标的执行率均有所提高，且执行率均>90%。另外，证据应用阶段患者 6 min 步行距离优于基线审查阶段（P<0.05）。结论：基于 i-PARIHS 框架的肺康复循证实践，有效提高了 HFNC 患者肺康复训练效果，增加患者活动耐力。

关键词: i-PARIHS 框架, 经鼻高流量氧疗, 肺康复训练