改良T组合复苏器与鼻导管吸氧用于婴儿电子支气管镜检查的安全性比较:一项前瞻性随机对照研究  

Safety of modified T-piece resuscitator versus nasal cannula oxygen in electronic bronchoscopy for infants:a prospective randomized controlled study

作　　者：宁俊杰 左智惠 喻志东[1] 李雪梅[1] 乔莉娜[2,3,4] NING Jun-Jie;ZUO Zhi-Hui;YU Zhi-Dong;LI Xue-Mei;QIAO Li-Na(Pediatric Intensive Care Unit,West China Second University Hospital,Sichuan University,Chengdu 610041,China;National Health Commission Key Laboratory of Chronobiology(Sichuan University),Chengdu 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Chengdu 610041,China)

机构地区：[1]自贡市第一人民医院儿科,四川自贡643000 [2]四川大学华西第二医院儿童重症医学科,四川成都610041 [3]国家卫生健康委员会时间生物学重点实验室(四川大学),四川成都610041 [4]出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《中国当代儿科杂志》2024年第1期37-41,共5页Chinese Journal of Contemporary Pediatrics

基　　金：国家重点研发计划(2021YFC2701700,2021YFC2701704)

摘　　要：目的优化肺部疾病婴儿接受支气管镜检查时的氧疗方案。方法该研究是一项前瞻性随机、对照的单中心临床试验。前瞻性选择2019年7月—2021年7月42例接受电子支气管镜检查的婴儿为研究对象。按照随机数字表法分为鼻导管吸氧(nasal cannula oxygen,NC)组及改良T组合复苏器(T-piece resuscitator,TPR)组。记录两组术中最低血氧饱和度结果作为主要指标,术中心率及呼吸结果作为次要指标。结果改良TPR组术中最低血氧饱和度高于NC组,低氧血症发生率低于NC组(P<0.05);改良TPR组术中有6例患儿轻度低氧、2例中度低氧及1例重度低氧,NC组分别有3、5和9例,差异有统计学意义(P<0.05)。改良TPR组术中呼吸节律异常发生率低于NC组(P<0.05),两组心律失常发生率差异无统计学意义(P>0.05)。结论改良TPR可以显著减少肺部疾病婴儿接受电子支气管镜时发生低氧血症的风险;与传统NC相比,TPR可明显改善低氧血症的严重程度,且减少呼吸节律异常的发生率。Objective To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy.Methods A prospective randomized,controlled,and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021.These infants were divided into a nasal cannula(NC)group and a modified T-piece resuscitator(TPR)group using a random number table.The lowest intraoperative blood oxygen saturation was recorded as the primary outcome,and intraoperative heart rate and respiratory results were recorded as the secondary outcomes.Results Compared with the NC group,the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia(P<0.05).In the modified TPR group,there were 6 infants with mild hypoxemia,2 with moderate hypoxemia,and 1 with severe hypoxemia,while in the NC group,there were 3 infants with mild hypoxemia,5 with moderate hypoxemia,and 9 with severe hypoxemia(P<0.05).The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group(P<0.05),but there was no significant difference in the incidence rate of arrhythmias between the two groups(P>0.05).Conclusions Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy,and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.

关 键 词：T组合复苏器 鼻导管吸氧 电子支气管镜 临床效果 婴儿 

分 类 号：R725[医药卫生—儿科]