探讨不同通气方式在困难气道高风险患者无痛胃镜检查过程中对应激反应水平的影响对比  

To explore the effects of different ventilation modes on stress response level during painless gas⁃troscopy in patients with high risk of difficult airway

作　　者：张婷婷 贾齐胜 吴利娟 Zhang Tingting;Jia Qisheng;Wu Lijuan(Outpatient Department of the First Affiliated Hospital of Henan University of Science and Technology,School of Nursing,Henan University of Science and Technology,Luoyang,Henan 471000;Emer-gency Department,New District Hospital,First Affiliated Hospital of Henan University of Science and Technology,School of Nursing,Henan University of Science and Technology,Luoyang,Henan 471000;Endoscopy Center,First Affiliated Hospital of Henan University of Science and Technology,School of Nursing,Henan University of Science and Technology,Luoyang,Henan 471000)

机构地区：[1]河南科技大学第一附属医院门诊河南科技大学护理学院,河南洛阳471000 [2]河南科技大学第一附属医院新区医院急诊科河南科技大学护理学院,河南洛阳471000 [3]河南科技大学第一附属医院内镜中心河南科技大学护理学院,河南洛阳471000

出　　处：《辽宁医学杂志》2023年第5期111-114,共4页Medical Journal of Liaoning

摘　　要：目的困难气道高风险患者无痛胃镜检查中应用经气管导管声门上通气或声门上喷射通气的效果及其对应激反应的影响。方法选取2019年2月至2021年2月期间河南科技大学第一附属医院收治的105例行无痛胃镜检查的困难气道高风险患者作为研究对象,以抽签的方法将其分为观察组和对照组。对照组52例给予声门上喷射通气,观察组53例给予经气管导管声门上通气。对比两组患者检查效果、生理指标、应激反应水平、不良事件发生率。结果观察组无痛胃镜检查时间低于对照组,苏醒时间高于对照组(P<0.05);检查前及检查后即刻,两组患者平均动脉压、心率、动脉血二氧化碳分压、血氧饱和度水平比较差异无统计学意义(P>0.05);检查后即刻,观察组患者肾上腺素(E)、皮质醇(Cor)水平均低于对照组(P<0.05);观察组呛咳、吞咽困难、声音嘶哑、肺气压伤发生率均低于对照组(P<0.05)。结论经气管导管声门上通气、声门上喷射通气均能够稳定无痛胃镜检查的困难气道高风险患者生理指标,发挥检查效果,但经气管导管声门上通气能够减少不良事件发生,减轻机体应激反应,其安全性优于声门上喷射通气,具备较高的临床推广价值。Objective To investigate the effect of supraglottal ventilation or supraglottal jet ventilation with tracheal tube in painless gastroscopy in patients with high risk of difficult airway and its effect on stress response.Methods A total of 105 patients with high risk of difficult airways who underwent painless gastroscopy in the First Affiliated Hospital of Henan University of Science and Technology from February 2019 to February 2021 were selected as subjects and divided in⁃to observation group and control group by lottery.Fifty⁃two patients in the control group were treated with supraglottic jet ventilation,and 53 patients in the observation group were treated with supraglottic ventilation through tracheal tube.The ex⁃amination effect,physiological indicators,stress response level and incidence of adverse events were compared between the two groups.Results The time of painless gastroscopy in the observation group was lower than that in the control group,and the time of awaken ing was higher than that in the control group(P<0.05).Before the examination and immediately after the examination,there was no significant difference in the mean arterial pressure,heart rate,arterial partial pressure of car⁃bon dioxide and blood oxygen saturation between the two groups(P>0.05).Immediately after examination,the levels of ep⁃inephrine(E)and cortisol(Cor)in observation group were lower than those in control group(P<0.05).The incidence of cough,dysphagia,hoarseness and pulmonary barometric injury in the observation group was lower than that in the control group(P<0.05).Conclusion The endotracheal tube glottis,glottis jet ventilation on ventilation can steady the painless gastroscopy difficult airway high⁃risk patients physiological indexes,check the effect,but the endotracheal tube on the glottis ventilation can reduce the adverse events,reduce the body′s stress response,its security is better than that of the glottis,jet ventilation has high clinical value.

关 键 词：生理指标 经气管导管声门上通气 无痛胃镜 困难气道高风险患者 应激反应 

分 类 号：R473.5[医药卫生—护理学]