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．