三种不同喷射通气方式在无痛纤维支气管镜检查中的应用比较  

Comparison of Application of Three Different Jet Ventilation Methods in Painless Fiberoptic Bronchoscopy

作　　者：黄晓娇 胡庭 刘雅静 HUANG Xiaojiao;HU Ting;LIU Yajing(Central Hospital of Xinyu Iron and Steel Group Co.,Ltd.,Xinyu 338001,China)

机构地区：[1]新余钢铁集团有限公司中心医院,江西新余338001

出　　处：《中国医学创新》2023年第19期42-47,共6页Medical Innovation of China

摘　　要：目的:对比三种不同喷射通气(jet ventilation,JV)方式在无痛纤维支气管镜(fiberoptic bronchoscopy,FOB)检查中的应用价值。方法:选取2019年8月—2022年10月在新余钢铁集团有限公司中心医院进行无痛FOB检查的100例患者作为本次研究对象,采用随机数字表法将其分为经鼻咽通气组(n=33,给予经鼻咽通气管JV)、经口咽通气组(n=33,给予经口咽通气管JV)及普通通气组(n=34,给予普通鼻导管JV),比较三组生命体征指标、动脉血气分析指标、检查时间、医患满意度及总不良事件发生率。结果:经鼻咽通气组进镜时(T_(1))、检查后5 min(T_(2))及检查结束时(T_(3))心率、MAP水平均低于经口咽通气组与普通通气组,差异均有统计学意义(P<0.05),血氧饱和度水平均高于经口咽通气组与普通通气组,差异均有统计学意义(P<0.05);经鼻咽通气组T_(2)、T_(3)时间点动脉血氧分压水平均高于自身麻醉前(T0)、同时间点经口咽通气组与普通通气组,差异均有统计学意义(P<0.05),但其T_(2)、T_(3)时间点动脉血二氧化碳分压水平均低于经口咽通气组与普通通气组,差异均有统计学意义(P<0.05);经鼻咽通气组置镜时间、镜检时间均短于经口咽通气组与普通通气组,差异均有统计学意义(P<0.05);经鼻咽通气组镜检医师满意度、患者舒适度均高于经口咽通气组与普通通气组,差异均有统计学意义(P<0.05);经鼻咽通气组总不良事件发生率为9.09%,低于经口咽通气组的30.30%,差异有统计学意义(P<0.05),低于普通通气组的38.24%,差异有统计学意义(P<0.05);而经口咽通气组与普通通气组相比以上指标虽存在差异,但差异无统计学意义(P>0.05)。结论:无痛FOB检查中使用经鼻咽通气管JV相比经口咽通气管JV及普通鼻导管JV给氧效果良好,患者血气指标稳定,医患满意度良好,且较为安全。Objective:To compare the application value of three different jet ventilation(JV)methods on painless fiberoptic bronchoscopy(FOB).Method:A total of 100 patients undergoing painless FOB examination in Central Hospital of Xinyu Iron and Steel Group Co.,Ltd.from August 2019 to October 2022 were selected as subjects of this study.Random number table method was used to divide the patients into the nasopharyngeal ventilation group(n=33,JV with nasopharyngeal ventilation tube),the oropharyngeal ventilation group(n=33,JV with oropharyngeal ventilation tube)and the common ventilation group(n=34,JV with common nasal catheter).The vital signs indexes,arterial blood gas analysis indexes,examination time,doctor-patient satisfaction and total incidence rate of adverse reactions were compared among the three groups of patients.Result:The heart rate and MAP in the nasopharyngeal ventilation group were lower than those in the oropharyngeal ventilation group and the common ventilation group at the time of scope admission(T_(1)),at 5 min after the examination(T_(2))and at the end of the examination(T_(3)),the differences were statistically significant(P<0.05),and the blood oxygen saturation was higher than that in the oropharyngeal ventilation group and the common ventilation group,the difference was statistically significant(P<0.05).The levels of arterial partial pressure of oxygen in the nasopharyngeal ventilation group at T_(2) and T_(3) were higher than that before anesthesia(T0)and those at the same time point in the oropharyngeal ventilation group and the common ventilation group,with statistical differences(P<0.05),but the levels of arterial partial pressure of carbon dioxide were lower than those in the oropharyngeal ventilation group and the common ventilation group at T_(2) and T_(3)(P<0.05).The scope placement time and scope examination examination in the nasopharyngeal ventilation group were shorter than those in the oropharyngeal ventilation group and the common ventilation group,with statistical differences(P<0.05).Th

关 键 词：鼻咽通气管喷射通气 经口咽通气管喷射通气 普通鼻导管喷射通气 无痛 纤维支气 管镜检查 

分 类 号：R614[医药卫生—麻醉学]