摘要
目的评价鼻咽通气道(nasopharyngeal airway,NPA)在超重与正常体质量人群无痛胃镜检查中预防低氧血症的效果。方法选取2019年11月至2022年2月于嘉兴学院附属医院接受无痛胃镜检查患者2000例为研究对象,根据随机数字表法将其分为NPA组和鼻氧管组,每组根据体质量指数(body mass index,BMI)进一步分为10个层级各纳入100例。鼻氧管组患者予常规鼻氧管吸氧,NPA组患者置入NPA后经该通道吸氧,氧流量均为4L/min。比较两组患者基础经皮动脉血氧饱和度(percutaneous arterial oxygen saturation,SpO_(2))、胃镜检查时间与麻醉期间轻度、中度和重度低氧血症的发生情况及不良反应发生情况。结果NPA组正常体质量人群轻度、中度低氧血症的发生率均低于鼻氧管组,超重人群轻度、中度及重度低氧血症的发生率均低于鼻氧管组(P<0.05)。相同BMI分层比较,与鼻氧管组相比,NPA组BMI≥23.0kg/m^(2)者轻度及中度低氧血症发生率更低,BMI≥28.0kg/m^(2)者重度低氧血症发生率更低(P<0.05)。NPA组患者术中呛咳及离院前恶心呕吐、头晕头痛发生率低于鼻氧管组,但鼻黏膜出血发生率高于鼻氧管组(P<0.05)。结论NPA的应用可显著降低超重与正常体质量人群无痛胃镜检查中低氧血症的发生率,且不良反应较少。
Objective To evaluate the efficacy of nasopharyngeal airway(NPA)on prevention of hypoxemia in patients with overweight and normal body mass undergoing painless gastroscopy.Methods A total of 2000 patients who received painless gastroscopy in the Affiliated Hospital of Jiaxing University from November 2019 to February 2022 were selected as the study objects.According to random number table method,they were divided into NPA group and nasal oxygen tube group,and each group was further divided into 10 levels according to body mass index(BMI),with 100 cases in each level.The nasal oxygen tube group was given oxygen through conventional nasal oxygen tube,and the NPA group was given oxygen through this channel after NPA insertion,and the oxygen flow rate was 4L/min in both groups.The percutaneous arterial oxygen saturation(SpO_(2)),time of gastroscopy,the occurrence of mild,moderate and severe hypoxemia during anesthesia,and the occurrence of adverse reactions were compared between the two groups.Results Compared with nasal oxygen tube group,the incidence of mild to moderate hypoxemia was lower in normal weight people in the NPA group,and the incidence of mild,moderate and severe hypoxemia was lower in overweight people in the NPA group(P<0.05).Comparison between two groups at the same BMI level,compared to nasal oxygen tube group,patients with BMI≥23.0kg/m^(2) had the lower incidence of mild and moderate hypoxemia in NPA group,and patients with BMI≥28.0kg/m^(2) had the lower incidence of severe hypoxemia in NPA group(P<0.05).The incidence of intraoperative cough,nausea,vomiting,dizziness and headache in NPA group was lower than that in nasal oxygen tube group,but the incidence of nasal mucosal bleeding was higher than that in nasal oxygen tube group(P<0.05).Conclusion The application of NPA can significantly reduce the incidence of hypoxemia during painless gastroscopy in overweight and normal weight population,and with fewer adverse reactions.
作者
邓康
刘明娟
袁孝忠
侯晓敏
李杰
姚明
DENG Kang;LIU Mingjuan;YUAN Xiaozhong;HOU Xiaomin;LI Jie;YAO Ming(Medical Center for Anesthesiology and Pain,Affiliated Hospital of Jiaxing University,Jiaxing 314001,Zhejiang,China)
出处
《中国现代医生》
2023年第7期37-41,共5页
China Modern Doctor
基金
浙江省省市共建医学重点学科建设计划项目(2019-ss-ttyx)
浙江省区域专病中心建设项目(201524)
嘉兴市科技计划项目(2021AD30168)。
关键词
无痛胃镜
体质量指数
鼻咽通气道
低氧
Painless gastroscopy
Body mass index
Nasopharyngeal airway
Hypoxia
