摘要
目的·探究PetCO_(2)监测型鼻咽通气道在阻塞型睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者无痛胃镜精查中的预防缺氧的效果。方法·选择2023年2—6月于河南省许昌市中心医院择期行胃镜精查麻醉的OSAS患者80例,随机将其分为PetCO_(2)监测型鼻咽通气道组(T组)和传统鼻咽通气道组(B组),每组40例。收集并比较2组患者的一般资料、围术期相关资料及麻醉用药量。观察2组患者麻醉前(T0)、麻醉后入镜时(T1)、入镜3 min(T2)、入镜10 min(T3)和退镜时(T4)的收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)和脉搏血氧饱和度(pulse oxygen saturation,SpO_(2)),并记录体动和低氧血症发生率以及其预防缺氧的效果(面罩加压给氧率、托下颌率和挤压胸廓辅助呼吸率)。结果·患者一般资料、围术期相关资料和麻醉用药量的组间差异均无统计学意义。在T1和T2时,T组患者的SpO_(2)高于B组(T1:P=0.041;T2:P=0.012),SBP、DBP和HR的组间差异无统计学意义;而在其余时间点,患者的该4个指标的组间差异亦均无统计学意义。与B组比较,T组患者的体动发生率、低氧血症发生率、面罩加压给氧率、托下颌率和挤压胸廓辅助呼吸率均较低(均P=0.000)。结论·PetCO_(2)监测型鼻咽通气道有利于实时观察OSAS患者在胃镜精查麻醉中的肺通气状态,并能够及时指导临床进行干预,降低术中低氧血症的发生率,从而提高麻醉的安全性。
Objective·To investigate the anesthetic effect of PetCO_(2)monitoring nasopharyngeal airway on preventing hypoxia in patients with obstructive sleep apnea syndrome(OSAS)during magnifying endoscopy.Methods·Eighty OSAS patients who underwent magnifying endoscopy anesthesia in Xuchang Central Hospital of Henan Province from February to June 2023 were randomly divided into PetCO_(2)monitoring nasopharyngeal airway group(group T)and traditional nasopharyngeal airway group(group B),with 40 cases in each group.General information,perioperative data and total anesthetic dosage of the two groups of patients were collected and compared.The systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and pulse oxygen saturation(SpO_(2))of the two groups of patients before anesthesia(T0),at the time of entering the endoscopy(T1),3 min after entering the endoscopy(T2),10 min after entering the endoscopy(T3)and at the end of endoscopy(T4)were observed and recorded,respectively.The incidence of body movement and hypoxemia,and the effects of preventing hypoxia(including mask ventilation,jaw-lift support and chest compressions to assist breath)of the two groups of patients were recorded.Results·There were no significant differences in general information,perioperative data and total anesthetic dosage between the two groups.At T1 and T2,SpO_(2)in group T was higher than that in group B(T1:P=0.041,T2:P=0.012),and there was no statistically significant difference in SBP,DBP and HR between the groups;at other time points,there was no statistically significant difference in the four indicators between the two groups.Compared with group B,the incidences of body movement,hypoxemia,mask ventilation,jaw-lift support and chest compressions to assist breath in group T were all decreased(all P=0.000).Conclusion·PetCO_(2)monitoring nasopharyngeal airway can reduce the incidence of hypoxia during magnifying endoscopy in patients with OSAS,with minimal adverse events.Also,it can detect the status of lung ventilation in time,guid
作者
吴雷
夏一梦
WU Lei;XIA Yimeng(Department of Anesthesiology,Xuchang Central Hospital of Henan Province,Xuchang 461000,China;Department of Anesthesiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2023年第12期1542-1547,共6页
Journal of Shanghai Jiao tong University:Medical Science
