预吸氧对肥胖患者无痛胃镜检查中低氧血症的预防作用  

Preventive effect of preoxygenation on hyoxemia in obese patients with painless gastroscopy

作　　者：王凤琴 王晓静 陆岳林 官玲玲 

机构地区：[1]江苏省徐州矿务集团第一医院消化内科,江苏徐州221131 [2]江苏省徐州矿务集团第一医院麻醉科,江苏徐州221131

出　　处：《实用临床医药杂志》2013年第24期57-60,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321171)

摘　　要：目的探讨预吸氧对肥胖患者无痛胃镜检查中低氧血症的预防作用。方法将182例体质量指数(BMI)≥30kg/m2的无痛胃镜检查患者随机分为观察组及对照组,每组91例。观察组于麻醉开始前给予面罩吸氧,对照组不给予预吸氧,进行自然呼吸。比较2组吸氧前、麻醉给药前即刻、胃镜检查30 s和60 s、胃镜检查结束即刻、苏醒后血氧饱和度(SpO2)、平均动脉压(MAP)及心率(HR)的变化,检查过程中SpO2各下降区间的例数,以及胃镜检查时间和丙泊酚用药总量。结果观察组麻醉给药前即刻、胃镜检查开始后30 s和60 s时,SpO2水平显著高于对照组;观察组SpO2<90%的比例显著低于对照组,且胃镜检查时间显著短于对照组,差异均有统计学意义。结论肥胖患者行无痛胃镜检查前采用面罩预吸氧的方式,可有效提高机体氧储备能力,减轻和预防静脉麻醉引起的呼吸抑制,降低发生低氧血症的风险,缩短胃镜检查时间,且对HR、血压等无显著影响。Objective To explore the preventive effect of preoxygenation on hyoxemia in obese patients with painless gastroscopy. Methods A total of 182 patients with body mass index （BMI） -30 kg/m2 who received painless gastroscopy were equally divided into observation group and control group. The observation group received the mask oxygen before anesthesia, while the control group took breath naturally. The changes of blood oxygen saturation （SpO2）, mean arterial pressure （MAP） and heart rate （HR） before oxygen inhalation, immediately before anesthesia, 30s and 60s during gastroscopy, immediately end, immediately reviving in two groups were compared. The cases of SpOz decline range during examination, examination time, total quantity of propofol administration in two groups were also compared. Results The levels of SpO2 immediately before anesthesia, 30 and 60 s during gastroscopy in observation group were obviously higher than that in the control group. The proportion of SpO2 〈 90 % in observation group and examination time were obviously shorter than in control group. The differences was statistical signifiant. Conclusion Mask preoxygenation used by obese patients with painless gastroscopy can effectively improve the body＇s oxygen reserve capacity, reduce and prevent respiratory inhibition caused by intravenous anesthesia, decrease the risk of hypoxemia, shorten the examination time of gastroseopy. Meanwhile, there is no significant effect on HR and blood pressure.

关 键 词：肥胖 体质量指数 无痛胃镜 面罩吸氧 预吸氧 

分 类 号：R723.14[医药卫生—儿科]