新型鼻咽通气道在老年患者无痛胃肠镜诊疗气道管理中的应用  

Application of new nasopharyngeal airway on airway management in elderly patients undergoing painless gastrointestinal endoscopy

作　　者：高源 刘丽[1] 乔辉[1] 王晓宁[1] 李天佐[1] GAO Yuan;LIU Li;QIAO Hui;WANG Xiaoning;LI Tianzuo(Department of Anesthesiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,100038

出　　处：《临床麻醉学杂志》2023年第5期497-500,共4页Journal of Clinical Anesthesiology

基　　金：国家重点研发计划(2018YFC2001800)。

摘　　要：目的评价新型鼻咽通气道在老年患者无痛胃肠镜诊疗中气道管理的安全性和有效性。方法选择拟行无痛胃肠镜检查的老年患者96例,男52例,女44例,年龄≥65岁,BMI 18~35 kg/m^(2),ASAⅠ或Ⅱ级,Mallampati分级Ⅰ或Ⅱ级。采用随机数字表法将患者分成两组:鼻咽通气道组(N组)和面罩组(M组),每组48例。麻醉诱导待患者睫毛反射消失后,N组经鼻腔插入新型鼻咽通气道,尾端连接供氧管路,M组行面罩通气。记录术中HR、MAP和SpO_(2)。记录麻醉药用量、诊疗操作时间、苏醒时间。记录HR<50次/分、MAP波动幅度超过基础值30%或MAP低于60 mmHg、低氧血症(SpO_(2)<92%)、气道干预操作、鼻黏膜损伤等不良反应发生情况。记录患者及内镜医师满意情况。结果N组在无痛胃肠镜诊疗过程中低氧血症发生率和需要气道干预操作的发生率明显低于M组(P<0.05)。N组内镜医师满意度明显高于M组(P<0.05)。N组有1例(2.1%)发生鼻黏膜损伤。两组HR<50次/分、MAP波动幅度超过基础值30%或MAP低于60 mmHg的发生率、麻醉药用量、诊疗操作时间、苏醒时间和患者满意度差异无统计学意义。结论新型鼻咽通气道可有效减少老年患者无痛胃肠镜低氧血症的发生,减少气道干预操作,提高内镜医师满意度,可安全有效应用于老年患者无痛胃肠镜诊疗。Objective To evaluate the safety and effectiveness of new nasopharyngeal airway in elderly patients undergoing painless gastrointestinal endoscopy.Methods Ninety-six elderly patients with painless gastrointestinal endoscopy,52 males and 44 females,aged≥65 years,BMI 18-35 kg/m^(2),ASA physical statusⅠorⅡ,MallampatiⅠorⅡ,were randomly divided into two groups:nasopharyngeal airway group(group N)and mask group(group M),48 patients in each group.After patients lost consciousness in the induction period,the new type of nasopharyngeal airway was inserted through the nasal cavity in group N,and the tail end was connected to an oxygen supply pipeline,and group M received oxygen through a mask.The basic information of the patient and intraoperative HR,MAP,SpO_(2),anesthetic dosage,operation time,recovery time were recorded.The incidence of adverse reactions such as HR<50 bpm,fluctuation in MAP>30%of baseline or MAP<60 mmHg,hypoxemia(SpO_(2)<92%),airway intervention,and nasal mucosa injury were recorded.The satisfaction of patients and endoscopists were also recorded.Results The incidence of hypoxemia and airway intervention in group N during painless gastrointestinal endoscopy were significantly lower than that in group M(P<0.05).The satisfaction of endoscopists in group N was higher than that in group M(P<0.05).In group N,one patient(2.1%)of nasal mucosal injury occurred.There were no significant differences in the incidence of HR<50 beats/min,fluctuation in MAP>30%of baseline or MAP<60 mmHg,anesthetic dosage,operation time,recovery time and patients satisfaction between the two groups.Conclusion The new nasopharyngeal airway can effectively reduce the occurrence of hypoxemia and airway intervention in elderly patients undergoing painless gastrointestinal endoscopy and improve the satisfaction of endoscopists.It can be safely and effectively applied to elderly patients receiving painless gastrointestinal endoscopy.

关 键 词：新型鼻咽通气道 老年患者 无痛胃肠镜 气道管理 

分 类 号：R614[医药卫生—麻醉学]