摘要
目的:比较经鼻高流量湿化氧疗(HFNC)与传统鼻导管氧疗(SNC)对阻塞性睡眠呼吸暂停综合征(OSAS)高危患者在全凭静脉麻醉下行前列腺靶向穿刺活检术时氧合的影响。方法:64例患者被纳入研究,随机分为两组。HFNC组(n=32)患者给予HFNC,CNC组(n=32)给予传统鼻导管。记录两组患者在手术期间血氧饱和度(SpO_(2))<95%的发生率,最低SpO_(2),记录患者入室时(T0)、手术开始时(T1)、手术结束时(T2)、手术结束后30 min(T3)等4个时间点的平均动脉压(MAP)、心率(HR)和SpO_(2)。记录患者T0、T2时的动脉氧分压(PaO_(2)),动脉二氧化碳分压(PaCO_(2)),以及需要气道干预和不良事件的发生率。结果:与CNC组相比,HFNC组最低SpO_(2)明显增高,PaO_(2)显著升高(P<0.05),PaCO_(2)无统计学差异。两组在手术时长、麻醉时长、丙泊酚用量方面均无明显差异,两组手术过程中低氧血症的发生率,以及气道干预、呛咳与体动的发生率之间,HFNC组明显低于CNC组(P<0.05)。结论:OSAS高危患者在全凭静脉麻醉下进行前列腺靶向穿刺活检时使用HFNC可以为患者提供更充分的氧合,更好的气道管理,减少低氧血症的发生率。
Objective:To compare the effect of high-flow nasal cannula oxygen therapy(HFNC)from that of conventional nasal cannula oxygen therapy(CNC)on oxygenation during prostate-targeted needle biopsy under total intravenous anesthesia in high-risk patients with obstructive sleep apnea syndrome(OSAS).Methods:We randomly assigned 64 high-risk OSAS patients to two groups of an equal number to receive HFNC and CNC,respectively,under total intravenous anesthesia.We recorded the incidence rates of SpO_(2)<95%and the lowest SpO_(2)during surgery,the mean arterial pressure(MAP),heart rate(HR)and oxygen saturation(SpO_(2))upon entering the operation room(T0),at the beginning(T1)and the end of surgery(T2)and at 30 minutes postoperatively(T3),as well as arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))at T0 and T2,and the incidence rates of airway intervention and adverse events,followed by comparison of the parameters between the two groups.Results:Both the lowest SpO_(2)and PaO_(2)were significantly increased in the HFNC group compared with those in the CNC group(P<0.05)while no statistically significant difference was observed in PaCO_(2)between the two groups(P>0.05).The intraoperative incidence rates of hypoxia,airway intervention,choking and body movement were remarkably lower in the HFNC than in the CNC group(P<0.05),but there were no statistically significant differences in the operation time,anesthesia duration and propofol dosage between the two groups(P>0.05).Conclusion:HFNC may provide more adequate oxygenation,improve airway management,and reduce the incidence of hypoxemia in high-risk OSAS patients during prostate biopsy under total intravenous anesthesia.
作者
曹雅男
肖悦
毛畅远
段文斌
胡益民
CAO Ya-nan;XIAO Yue;MAO Chang-yuan;DUAN Wen-bin;HU Yi-min(Graduate School,Bengbu Medical College,Bengbu,Anhui 233000,China;Department of Anesthesiology,Changzhou Second People’s Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu 2130003,China)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2022年第7期585-589,共5页
National Journal of Andrology
基金
常州市应用基础研究计划项目(CJ20210112)。
