高流量预氧合技术在胸腹部恶性肿瘤放疗中的可行性研究  

Feasibility study of high-fl ow preoxygenation in radiotherapy for thoracic and abdominal malignancies

作　　者：姚国荣[1,2] 赵峰 周子洋[1,3] 徐嘉琪 陆中杰 严森祥[1] Yao Guorong;Zhao Feng;Zhou Ziyang;Xu Jiaqi;Lu Zhongjie;Yan Senxiang(Department of Radiotherapy,the First Affi liated Hospital,Zhejiang University School of Medicine,Hangzhou 311121,China;Key Laboratory of Pulsed Power Translational Medicine of Zhejiang Province,Hangzhou 311100,China;School of Medicine,Zhejiang University,Hangzho u 310003,China)

机构地区：[1]浙江大学医学院附属第一医院放疗科,浙江杭州311121 [2]浙江省脉冲电场技术医学转化重点实验室,浙江杭州311100 [3]浙江大学医学院,浙江杭州310003

出　　处：《实用肿瘤杂志》2023年第6期537-542,共6页Journal of Practical Oncology

基　　金：浙江省重点研发计划(2021C03122);国家自然科学基金(82171890,81701683);浙江省教育厅科研项目(Y202148354)。

摘　　要：目的探索高流量预氧合技术在胸腹部恶性肿瘤放疗中的可行性及其临床价值。方法自2022年1月至2022年2月于浙江大学医学院附属第一医院招募20名健康志愿者行高流量预氧合后单次深吸气屏气测试并采用随机数字表法选取其中10名志愿者进行预氧合后6个循环连续屏气能力测试,并收集临床资料。评估预氧合前后的屏气时长、多次循环屏气能力和各项生命体征变化情况,制定可行的预氧合方案。结果20名志愿者进行适度深吸气屏气(室内空气)、最大限度深吸气屏气(室内空气)、预氧合吸氧5 min后最大限度深吸气屏气和预氧合吸氧10 min后最大限度深吸气屏气,屏气时长分别为(48.87±12.65)s、(59.10±13.88)s、(109.02±29.01)s和(113.85±31.25)s。预氧合吸氧5 min和10 min均可有效提升屏气时长,与最大限度深吸气屏气比较,差异均具有统计学意义(均P<0.05)。预氧合吸氧10 min与5 min后屏气时长比较,差异无统计学意义(P=0.615)。10名志愿者行预氧合吸氧5 min后最大限度深吸气屏气,并进行6次循环屏气测试,屏气时长为(103.21±20.31)s。6次屏气时长比较,差异无统计学意义(P=0.261)。20名志愿者试验过程中血氧饱和度、血压和心率等各项指标未有明显变化(均P>0.05)。结论5 min高流量预氧合技术可以有效提升屏气时长,对于胸腹部恶性肿瘤放疗中呼吸运动控制是可行的,具有较高的临床应用价值。Objective To explore the feasibility and clinical value of high-flow preoxygenation technology in the radiotherapy for thoracic and abdominal malignant tumors.Methods From January 2022 to February 2022,20 healthy volunteers were recruited from the First Affiliated Hospital of Zhejiang University School of Medicine to undergo a single deep inspiration breath-hold(DIBH)test after high-flow preoxygenation,and 10 of them were randomly selected by random number table to undergo a continuous breath-holding test for six cycles after preoxygenation.The clinical data were collected.The duration of breath holding,ability to hold breath multiple times,and changes in various vital signs before and after preoxygenation were evaluated,and a feasible preoxygenation plan was developed.Results 20 volunteers underwent moderate DIBH(room air),maximum DIBH(room air),and maximum DIBH after 5 min and 10 min of preoxygenation.The durations of breath holding were(48.87±12.65)s,(59.10±13.88)s,(109.02±29.01)s,and(113.85±31.25)s,respectively.After 5 min and 10 min of preoxygenation,the durations were effectively increased(both P<0.05)compared to the maximum DIBH(room air).There was no statistically significant difference in breath-holding duration between maximum DIBH after 10 min and that after 5 min of preoxygen-ation(P=0.615).Ten volunteers underwent preoxygenation for 5 min,followed by maximum DIBH,and six cycles of breath-holding tests,with an average duration of(103.21±20.31)s.There was no statistically significant difference in the duration among six breath-holding sessions(P=0.261).There were no significant changes in various indicators such as blood oxygen saturation,blood pressure,and heart rate during the tests of 20 volunteers(all P>0.05).Conclusions The 5 min high-flow preoxygenation technology can effectively lengthen the duration of breath holding.It is feasible for respiratory movement control in radiotherapy for thoracic and abdominal malignant tumors,and has high clinical application value.

关 键 词：放射治疗 高流量预氧合 屏气 非再吸入性面罩 

分 类 号：R730.55[医药卫生—肿瘤]