NoSAS评分在识别深度镇静支气管镜检查期间低氧血症高风险群体中的应用  

Application of NoSAS score in identifying high-risk groups for hypoxemia during deep sedation bronchoscopy

作　　者：祝丁 周家明 张雯[2,4] ZHU Ding;ZHOU Jiaming;ZHANG Wen(Institute of Medicine(HIM),Zhejiang Cancer Hospital,Hangzhou 310022,China)

机构地区：[1]浙江省肿瘤医院综合内科,浙江杭州310022 [2]中国科学院杭州医学研究所 [3]浙江省肿瘤医院内镜科 [4]浙江省肿瘤医院麻醉科

出　　处：《全科医学临床与教育》2024年第1期36-40,共5页Clinical Education of General Practice

摘　　要：目的 探索NoSAS评分在识别深度镇静支气管镜检查期间低氧血症高风险群体中的应用价值。方法 选择接受深度镇静支气管镜检查的293例患者作为研究对象。据NoSAS评分标准分为阻塞性睡眠呼吸暂停综合征(OSAS)高风险组和低风险组。比较两组患者在深度镇静支气管镜期间低氧血症等心肺不良事件的发生率和气道干预率。对发生低氧血症的影响因素进行单因素分析和多因素logistic回归分析。结果 与OSAS低风险组相比,高风险组发生低氧血症、严重低氧血症、气道干预(托下颌、提高氧流量、储氧面罩通气)的频率更高,差异均有统计学意义(χ~2分别=8.47、5.51、14.36、4.52、8.48,P均<0.05)。logistic多因素分析显示OSAS高风险组较低风险组显著增加深度镇静支气管镜检查期间发生低氧血症的风险(OR=2.38,95%CI 1.28~4.43,P<0.05)。结论 NoSAS评分有助于识别深度镇静支气管镜检查期间发生低氧血症高风险的群体,为预防及干预低氧血症提供重要依据。Objective To explore the application value of NoSAS score in identifying high-risk groups for hypoxemia during deep sedation bronchoscopy.Methods Totally 293 patients who underwent deep sedation bronchoscopy were selected as the subjects.Patients were divided into obstructive sleep apnea syndrome(OSAS) high-risk group and OS AS low-risk group according to NoSAS score.The incidence of cardiopulmonary adverse events such as hypoxemia and airway intervention rates between two groups of patients during deep sedation bronchoscopy were compared.Univariate analysis and multivariate logistic regression analysis were conducted on the influencing factors of hypoxemia.Results C.ompared with the low-risk group,the high-risk group had a higher frequency of hypoxemia,severe hypoxemia,and airway intervention(jaw lift,increase the flow of oxygen,bag-mask ventilation),and the differences were statistically significant(χ~2=8.47,5.51,14.36,4.52,8.48,P<0.05).Logistic multivariate analysis further showed that the high-risk group significantly increased the risk of hypoxemia during deep sedation bronchoscopy when compared to the low-risk group,with statistical significance(OR=2.38,95%CI 1.28-4.43,P<0.05).Conclusion The NoSAS score helps to identify high-risk groups for hypoxemia during deep sedation bronchoscopy,and provid a valuable evidence for active prevention and intervention of hypoxemia.

关 键 词：NoSAS评分 阻塞性睡眠呼吸暂停综合征 深度镇静 支气管镜 低氧血症 

分 类 号：R614[医药卫生—麻醉学]