鼻咽通气道给氧在OSAHS患者无痛支气管镜检查中的应用效果观察

发布时间：2018-03-27 22:07

本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：鼻咽通气道　出处：《山东医药》2017年24期

【摘要】：目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者无痛支气管镜检查中采用鼻咽通气道给氧的应用效果。方法将40例OSAHS患者随机分为鼻咽通气道组、内镜面罩组,每组20例。两组麻醉后鼻咽通气道组经鼻咽通气道给氧、内镜面罩组采用内镜面罩给氧,常规行无痛支气管镜检查。记录两组入室前(T0)、麻醉诱导并给氧后5 min(T1)、丙泊酚给药后10 min(T2)、术毕(T3)、苏醒后即刻(T4)的血氧饱和度(Sp O2)、呼气末CO2分压(PETCO2),手术时间、气管镜一次性通过率、镜检条件满意度评分以及不良反应发生率。结果鼻咽通气道组T2、T3时间点Sp O2均高于内镜面罩组,PETCO2均低于内镜面罩组(P均0.05)。两组T0、T1、T4时间点Sp O2、PET CO2比较差异均无统计学意义(P均0.05)。两组气管镜一次性通过率均为95%(19/20)。鼻咽通气道组镜检条件满意度评分明显高于内镜面罩组,两组比较P0.05。两组手术时间比较差异无统计学意义(P0.05)。鼻咽通气道组上呼吸道梗阻、高血压、心动过速发生率均低于内镜面罩组(P均0.05)。结论 OSAHS患者支气管镜检查中应用鼻咽通气道给氧较内镜面罩可更好地维持氧合,利于检查操作且安全性高。
[Abstract]:Objective to observe the application effect of nasopharyngeal airway oxygen supply in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by painless bronchoscopy. Methods 40 patients with OSAHS were randomly divided into two groups: nasopharyngeal ventilation group and endoscopic mask group. 20 cases in each group. After anesthesia, the nasopharynx ventilation group was given oxygen through the nasopharynx airway, and the endoscopic mask group was given oxygen by endoscopic mask. Routine painless bronchoscopy was performed. The blood oxygen saturation of the two groups was recorded before and 5 minutes after anesthesia induction and oxygen administration, 10 minutes after propofol administration, 10 minutes after administration of propofol, T3, T4 immediately after recovery), and PETCO2 at the end of expiratory pressure (PETCO2). The time of operation was one time pass rate of tracheoscope. Results SPO _ 2 in nasopharyngeal ventilation group was higher than that in endoscopic mask group at T _ 2T _ 3 time point (P < 0.05), but there was no statistical difference between two groups in Sp _ 2O _ 2 CO2 at T _ (0) T _ (1) T _ (1) T _ (4) and T _ (0) T _ (1) T _ (4) time point. The two groups had a one-off pass rate of 95 / 20. The satisfaction score of the nasopharynx ventilation group was significantly higher than that of the endoscopic mask group, and the degree of satisfaction was significantly higher in the nasopharynx ventilation group than in the endoscopic mask group. There was no significant difference in operation time between the two groups. The incidence of tachycardia was lower than that in the endoscopic mask group (P < 0.05). Conclusion the nasopharyngeal airway oxygen supply in patients with OSAHS can maintain oxygenation better than that in the endoscopic mask, which is beneficial to the operation and safety of the examination.
【作者单位】：河南省人民医院;
【基金】：郑州市科技局普通科技攻关计划项目(121PPTGG492-5)
【分类号】：R766

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