本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點：鼻咽通氣道　出處：《山東醫(yī)藥》2017年24期

【摘要】：目的觀察阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者無痛支氣管鏡檢查中采用鼻咽通氣道給氧的應用效果。方法將40例OSAHS患者隨機分為鼻咽通氣道組、內鏡面罩組,每組20例。兩組麻醉后鼻咽通氣道組經鼻咽通氣道給氧、內鏡面罩組采用內鏡面罩給氧,常規(guī)行無痛支氣管鏡檢查。記錄兩組入室前(T0)、麻醉誘導并給氧后5 min(T1)、丙泊酚給藥后10 min(T2)、術畢(T3)、蘇醒后即刻(T4)的血氧飽和度(Sp O2)、呼氣末CO2分壓(PETCO2),手術時間、氣管鏡一次性通過率、鏡檢條件滿意度評分以及不良反應發(fā)生率。結果鼻咽通氣道組T2、T3時間點Sp O2均高于內鏡面罩組,PETCO2均低于內鏡面罩組(P均0.05)。兩組T0、T1、T4時間點Sp O2、PET CO2比較差異均無統(tǒng)計學意義(P均0.05)。兩組氣管鏡一次性通過率均為95%(19/20)。鼻咽通氣道組鏡檢條件滿意度評分明顯高于內鏡面罩組,兩組比較P0.05。兩組手術時間比較差異無統(tǒng)計學意義(P0.05)。鼻咽通氣道組上呼吸道梗阻、高血壓、心動過速發(fā)生率均低于內鏡面罩組(P均0.05)。結論 OSAHS患者支氣管鏡檢查中應用鼻咽通氣道給氧較內鏡面罩可更好地維持氧合,利于檢查操作且安全性高。
[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.
【作者單位】： 河南省人民醫(yī)院;
【基金】：鄭州市科技局普通科技攻關計劃項目(121PPTGG492-5)
【分類號】：R766

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