经鼻高流量氧疗对鼻内镜低温等离子切除扁桃体腺样体术后的影响  

Effect of High Flow Nasal Cannula in Tonsillectomy and Adenoidectomy After Endoscopic Low Temperature Plasma

作　　者：刘兴利[1] 周亚平[2] 杜欣 LIU Xingli;ZHOU Yaping;DU Xin(Total Quality Management Office,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Otolaryngology Department,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第二附属医院全面质量管理办公室,河南洛阳471000 [2]河南科技大学第二附属医院耳鼻咽喉科,河南洛阳471000

出　　处：《河南医学研究》2023年第20期3745-3749,共5页Henan Medical Research

摘　　要：目的 探讨经鼻高流量氧疗对鼻内镜低温等离子切除扁桃体腺样体术后的影响。方法 选取医院2020年1月至2022年12月收治的86例阻塞性睡眠呼吸暂停低通气综合征患儿,采用随机数字表法分为观察组和对照组,各43例。两组均接受低温等离子切除扁桃体腺样体术,对照组接受常规氧疗方案,观察组接受经鼻高流量氧疗方案。比较两组血气指标、疼痛程度、多导睡眠图结果、低氧血症发生率和呼吸不良事件(RAE)发生率。结果 拔管后,观察组动脉血氧分压(PaO2)高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。术后1、3、5 d,观察组视觉模拟评分法(VAS)评分低于对照组(P<0.05)。出院3个月后,观察组呼吸暂停低通气指数(AHI)低于对照组,最低血氧饱和度(LSaO2)高于对照组(P<0.05)。术后,观察组低氧血症发生率(11.63%)与RAE发生率(30.23%)低于对照组(30.23%、72.09%)(P<0.05)。结论 经鼻高流量氧疗在低温等离子切除扁桃体腺样体手术的麻醉诱导期间,能提供更加适宜的氧气支持,增加氧合,延长插管的安全窒息时间,防止患儿出现低氧血症。Objective To explore the effect of high flow nasal cannula in tonsillectomy and adenoidectomy after endoscopic low temperature plasma.Methods A total of 86 pediatric patients with obstructive sleep apnea hypopnea syndrome admitted to the hospital from January 2020 to December 2022 were selected and divided into observation group and control group by random number table,with 43 cases in each group.Both groups underwent endoscopic low temperature plasma in tonsillectomy and adenoidectomy,the control group received conventional oxygen therapy and the observation group received high flow nasal cannula.Blood gas measures,pain level,polysomnographic results,incidence of hypoxemia and incidence of respiratory adverse events(RAE)were compared.Results After extubation,compared with the control group,partial pressure of oxygen(PaO_(2))in observation group was higher,and partial pressure of carbon dioxide(PaCO_(2))was lower(P<0.05).1,3 and 5 days after surgery,the visual analogue scale score(VAS)of the observation group were lower than the control group(P<0.05).Three months after discharge,the observation group had lower apnea hypopnea index(AHI)and higher LSaO_(2) than the control group(P<0.05).After treatment,the incidence of hypoxemia(11.63%)and RAE(30.23%)of the observation group was lower than those(30.23%,72.09%)of the control group(P<0.05).Conclusion High flow nasal cannula can provide more appropriate oxygen support,increase oxygenation,prolong the safe asphyxia time of intubation,and prevent hypoxemia in children.

关 键 词：氧吸入疗法 扁桃体切除术 腺样体切除术 并发症 低氧血症 

分 类 号：R459.6[医药卫生—治疗学]