摘要
目的评价改良鼻咽通气道机械通气用于肥胖患者无痛胃镜检查的效果。方法抽取郑州大学第一附属医院2021年2月至2021年10月行无痛胃镜检查患者180例,性别不限,年龄18~65岁,美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级,体质指数≥28 kg/m^(2),采用随机数字表法分为鼻导管吸氧组(C组)、改良鼻咽通气道吸氧组(O组)和改良鼻咽通气道机械通气组(N组),每组60例。C组经鼻导管吸纯氧5 L/min;O组置入改良鼻咽通气道,经其吸纯氧5 L/min;N组置入改良鼻咽通气道,并连接麻醉机机械通气。记录检查过程中缺氧相关不良事件(亚临床呼吸抑制、缺氧和重度缺氧)发生情况及处理措施(抬下颌、面罩加压通气和气管插管机械通气)使用情况。记录检查过程中及术后体动、呛咳、鼻出血、咽痛和口腔干燥等不良反应的发生情况。结果与C组比较,O组亚临床呼吸抑制和缺氧发生率降低,抬下颌使用率降低,呛咳发生率降低(P<0.05);N组亚临床呼吸抑制、缺氧及重度缺氧发生率降低,抬下颌和面罩加压通气使用率降低,呛咳发生率降低(P均<0.05)。N组缺氧发生率为1.7%(1/60),抬下颌使用率为1.7%(1/60),低于O组的13.3%(8/60)、16.7%(10/60),P均<0.05。三组体动、鼻出血、咽痛和口腔干燥发生率比较差异未见统计学意义(P>0.05)。结论改良鼻咽通气道机械通气用于肥胖患者无痛胃镜检查术安全、有效。
Objective To evaluate the effect of modified nasopharyngeal airway mechanical ventilation during painless gastroscopy in obese patients.Methods One hundred and eighty male or female patients treated in the First Affiliated Hospital of Zhengzhou University from February 2021 to October 2021 were selected,who underwent painless gastroscopy,aged 18-65 years,at American Society of Anesthesiologists physical statusⅠorⅡ,with body mass index≥28 kg/m^(2).And they were divided into the supplementary oxygen via nasal cannula group(group C),the supplementary oxygen via modified nasopharyngeal airway group(group O)and the ventilation via modified nasopharyngeal airway group(group N)by random number table method,with 60 cases in each group.Patients in the group C were given oxygen therapy(pure oxygen,5 L/min)via a nasal cannula.Patients in the group O were given oxygen therapy(pure oxygen,5 L/min)via modified nasopharyngeal airway.Patients in the group N were given ventilation via a modified nasopharyngeal airway by connecting an anesthetic machine.The occurrence of hypoxia related adverse events(subclinical respiratory depression,hypoxia and severe hypoxia)and the use of treatment measures(jaw lifting,mask pressure ventilation and endotracheal intubation mechanical ventilation)were recorded.The occurrence of adverse reactions such as body movement,choking,epistaxis,pharyngalaia and xerostomia during and after the examination were recorded.Results Compared with the group C,the group O had lower incidences of subclinical respiratory depression and hypoxia,reduced requirement of jaw lifting,and decreased incidence of choking(all P<0.05),while the group N had lower incidence of subclinical respiratory depression,hypoxia and severe hypoxia,decreased requirement of jaw lifting and mask ventilation,and reduced incidence of choking(all P<0.05).The incidence of hypoxia in the group N was 1.7%(1/60),and the utilization rate of jaw lifting was 1.7%(1/60),which was lower than 13.3%(8/60)and 16.7%(10/60)in the group O(all P<0.05).There was no significant difference in the incidence of body movement,epistaxis,pharyngalgia,and xerostomia among the three groups(P>0.05).Conclusions The modified nasopharyngeal airway ventilation is safe and effective in painless gastroscopy examination for obese patients.
作者
王绪林
李艳娜
张建文
李平乐
邢飞
曾晓曼
邢娜
Wang Xulin;Li Yanna;Zhang Jianwen;Li Pingle;Xing Fei;Zeng Xiaoman;Xing Na(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2022年第12期5-9,共5页
Chinese Journal of Practical Medicine
基金
河南省医学适宜技术推广项目 (SYJS2020114)。
关键词
胃镜检查
气道管理
肥胖
缺氧
Gastroscopy
Airway management
Obesity
Hypoxia
