高流量鼻导管通气用于全凭静脉全身麻醉下宫腔镜手术患者供氧的临床疗效  

Clinical efficacy of high flow nasal cannula for oxygen supply in patients undergoing hysteroscopic surgery under total intravenous anesthesia

作　　者：孙美娟 杜娟 叶炜 熊祥生 孙小婧 姚盛来 SUN Meijuan;DU Juan;YE Wei;XIONG Xiangsheng;SUN Xiaojing;YAO Shenglai(Department of Anesthesiology,Huaian Hospital Affiliated to Yangzhou University/The Fifth People's Hospital of Huaian,Huaian,Jiangsu,223300,China)

机构地区：[1]扬州大学附属淮安医院/淮安市第五人民医院麻醉科,江苏淮安223300

出　　处：《当代医学》2025年第1期120-123,共4页Contemporary Medicine

摘　　要：目的探讨高流量鼻导管通气(high flow nasal cannula,HFNC)用于全凭静脉全身麻醉下宫腔镜手术患者供氧的临床疗效。方法选取2024年1—5月淮安市第五人民医院收治的60例全身麻醉下行宫腔镜手术患者作为研究对象,按照供氧方式不同分为面罩组与HFNC组,每组30例。两组均以舒芬太尼及丙泊酚全凭静脉麻醉,面罩组以麻醉机面罩吸氧,HFNC组以HFNC供氧。比较两组手术中因血氧饱和度(pulse oxygen saturation,SpO 2)下降(<90%)需用麻醉机手控面罩加压给氧占比及不同时间点[入室后尚未吸氧(T0)、吸氧后至麻醉诱导前(T1)、手术开始后10 min(T2)、手术开始后20 min(T3)]收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)、SpO 2。结果HFNC组术中因SpO 2下降(<90%)需用麻醉机手控面罩加压给氧辅助呼吸占比为6.67%,低于面罩组的26.67%,差异有统计学意义(P<0.05)。T0~T3,两组SBP、DBP、HR、SpO 2比较差异均无统计学意义。结论HFNC用于全凭静脉全身麻醉下宫腔镜手术患者的术中供氧效果显著,能维持较好的氧合指标,值得临床推广应用。Objective To investigate the clinical efficacy of high flow nasal catheter ventilation(HFNC)for oxygen supply in patients undergoing hysteroscopic surgery under total intravenous anesthesia.Methods 60 patients undergoing hysteroscopic surgery under total general anesthesia treated in the Fifth People's Hospital of Huaian from January to May 2024 were selected as the study subjects,and they were divided into the mask group and the HFNC group according to different oxygen supply methods,with 30 cases in each group.Sufentanil and propofol were given intravenous anesthesia in both groups,the mask group was given oxygen through the mask of the anesthesia machine,and the HFNC group was given HFNC.The proportion of manual mask pressure oxygen given by anesthesia machine due to pulse oxygen saturation(SpO 2)decrease(<90%)during surgeny and systolid blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),SpO 2 at different time points(no oxygen on admission[T0],after oxygen to before anesthesia induction[T1],10 min after surgery[T2],20 min after surgery[T3])and were compared between the two groups.Results The proportion of manual mask pressure oxygen given by anesthesia machine due to SpO 2 decrease(<90%)during surgeny in the HFNC group was 6.67%,which was lower than 26.67%in the mask group,and the difference was statistically significant(P<0.05).T0-T3,there were no significant difference in SBP,DBP,HR and SpO 2 between the two groups.Conclusion HFNC has remarkable effect on intraoperative oxygen supply for hysteroscopic surgery patients under total intravenous anesthesia,and can maintain a good oxygenation index,which is worthy of clinical promotion and application.

关 键 词：经鼻湿化高流量鼻导管通气 宫腔镜 全凭静脉全身麻醉 低氧血症 

分 类 号：R614[医药卫生—麻醉学]