摘要
目的探讨经鼻高流量氧疗对肥胖患者实施无痛结肠镜检查安全性的影响。方法选择在西安交通大学第一附属医院实施无痛结肠镜检查的肥胖患者100例,ASA分级Ⅰ~Ⅲ级,BMI≥28 kg/m^2。将患者按照随机数字表法分为试验组(H组,给予经鼻高流量氧疗,氧流量20~60 L/min)和对照组(C组,常规鼻导管吸氧,氧流量为3~5 L/min),每组50例。分别记录两组患者入室即刻(T0)、进镜后1 min(T1)、进镜至回肠末端(T2)和离院即刻(T3)的MAP、心率和SpO2,紧急情况处理发生率,丙泊酚用药总量,结肠镜检查时间,苏醒时间,不良反应,以及内镜医师和患者的满意度。结果H组患者与C组患者的一般情况、不良反应发生率以及丙泊酚用药总量、内镜检查时间和苏醒时间之间比较差异无统计学意义(P>0.05);T1时点,H组的SpO2明显高于C组(P<0.05);H组的紧急情况处理例数为11例(22%),明显低于C组的33例(66%)(P<0.05);H组的内镜医师满意度和患者满意度明显高于C组(P<0.05)。结论经鼻高流量氧疗可以提高肥胖患者实施无痛结肠镜检查的安全性。
Objective To investigate the safety of painless colonoscopy in the treatment of obese patients during high-flow nasal cannula oxygen therapy.Methods A total of 100 obese patients,ASAⅠ−Ⅲ,BMI≥28 kg/m^2,who underwent painless colonoscopy in the First Affiliated Hospital of Xi'an Jiaotong University were selected.According to the random number table method,the patients were divided into two groups(n=50):an experimental group(group H,who received high-flow nasal cannula oxygen therapy,at an oxygen flow of 20−60 L/min)and a control group(group C,who underwent conventional oxygen inhalation via nasal catheter,at an oxygen flow of 3-5 L/min).Then,their mean arterial pressure(MAP),heart rate and saturation of pulse oximetry(SpO2)at T0(immediately after entry into operation room),T1(1 min after colonoscope insertion),T2(when insertion of the tip of the colonoscope into the terminal ileum)and T3(immediately before hospital discharge)were recorded.Furthermore,the incidence of emergency management,the total dosage of propofol,the length of colonoscopy procedure,the awakening time,adverse reactions,and the satisfaction of endoscopists and patients were also recorded.Results There was no significant difference between group H and group C in general condition,the incidence of adverse reactions,the total dosage of propofol,the length of endoscopic examination and recovery time(P>0.05).Group H produced remarkable increases in SpO2 at T1 compared with group C(P<0.05).There were 11 cases(22%)of emergency treatment for group H,which were significantly lower than 33 cases(66%)in group C(P<0.05).The satisfaction of both endoscopists and patients from group H was significantly higher than that of group C(P<0.05).Conclusions High-flow nasal cannula oxygen therapy can improve the safety of painless colonoscopy examination in obese patients.
作者
郑少华
李欣
每晓鹏
周艳楠
向佩
史博文
Zheng Shaohua;Li Xin;Mei Xiaopeng;Zhou Yannan;Xiang Pei;Shi Bowen(Department of Anesthetic Operation,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Department of Anesthesiology,Xi′an International Medical Center Hospital,Xi′an 710100,China)
出处
《国际麻醉学与复苏杂志》
CAS
2020年第11期1052-1056,共5页
International Journal of Anesthesiology and Resuscitation
基金
中华医学会消化内镜学会科研基金(CSDE012017120009)
西安交通大学临床新技术(XJLS-2018-022)。
