声门前高流量给氧在肥胖患者无痛胃镜检查中的应用  

Application of High Flow Preglottic Oxygen Therapy in Painless Gastroscopy in Obese Patients

作　　者：王启明 董丽露 罗成 WANG Qi-ming;DONG Li-lu;LUO Cheng(Department of Anesthesiology,The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023)

机构地区：[1]广西中医药大学第一附属医院麻醉科,广西南宁530023

出　　处：《医学临床研究》2022年第2期215-218,共4页Journal of Clinical Research

基　　金：广西壮族自治区卫生健康委会自筹经费科研课题(Z20211333)。

摘　　要：【目的】探讨声门前高流量给氧在肥胖患者无痛胃镜检查的安全性和可行性。【方法】80例行无痛胃镜检查的肥胖患者按随机数字表法分为观察组(A组)和对照组(B组),每组40例。A组采用声门前高流量给氧(氧流量8~10 L),B组采用传统的鼻导管给氧(氧流量3 L),比较两组麻醉前(T_(0))、麻醉后睫毛反射消失时(T_(1))、睫毛反射消失后2 min(T_(2))、胃镜检查结束清醒时(T_(3))患者平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉博血氧饱和度(SpO_(2))变化情况;比较两组舌根后坠、需托下颌或面罩辅助通气的情况以及丙泊酚用量、胃镜检查操作时间、苏醒时间。【结果】两组患者T_(0)、T_(1)、T_(2)、T_(3)时点MAP、HR、RR比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)时点,A组SpO_(2)高于B组,差异有统计学意义(P<0.05)。A组低氧血症例数、需托下颌例数均为零例,均显著低于B组(低氧血症6例、需托下颌14例),其差异有统计学意义(P<0.05)。两组患者丙泊酚总用量、胃镜检查操作时间、苏醒时间比较差异均无统计学意义(P>0.05)。【结论】声门前高流量给氧用于肥胖患者无痛胃镜检查中,能显著改善患者SpO_(2)水平,提高麻醉安全性,值得临床推广应用。【Objective】To investigate the safety and feasibility of preglottic high flow oxygen in painless gastroscopy in obese patients.【Methods】Eighty obese patients undergoing painless gastroscopy were randomly divided into the observation group(group A)and the control group(group B),with 40 cases in each group.Group A was given preglottic high-flow oxygen(oxygen flow 8-10L/min),while group B was given traditional nasal catheter oxygen(oxygen flow 3L/min).The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),and arterial oxygen saturation(SpO_(2))before anesthesia(T0),at the time of disappearance(T_(1)),2 minutes after the disappearance of eyelash reflexes(T_(2)),and awake at the end of gastroscopy(T_(3))were compared between the two groups.Meanwhile the tongue base fall,jaw support or mask assisted ventilation,the dosage of propofol,the gastroscopy operation time and the awakening time were also compared.【Results】Levels of MAP,HR and RR at T0,T_(1),T_(2),and T_(3) between the two groups of patients were not statistically significant(P>0.05).The SpO_(2) levels of group A with high-flow preglottic oxygen at T_(1) and T_(2) were higher than those of group B with nasal cannula oxygen,the differences were statistically significant(P<0.05).The number of hypoxemia and jaw support in group A were 0,which were significantly lower than those in group B(6 cases of hypoxemia and 14 cases of mandibular support).The difference was statistically significant(P<0.05).There were no statistically significant differences in the total dosage of propofol,gastroscope operation time and anesthesia recovery time between the two groups(P>0.05).【Conclusion】In the painless gastroscopy of obese patients,preglottic high-flow oxygen can significantly improve the SpO_(2) level and improve the safety of anesthesia,which is worthy of clinical promotion.

关 键 词：肥胖症 胃镜检查 氧吸入疗法 

分 类 号：R446.112[医药卫生—诊断学]