无痛胃镜给氧模式的探讨

目的探讨无痛胃镜检查过程中的最佳给氧模式。方法 566例无痛胃镜受检者,按随机数字法分为6组:未给预吸氧组(麻醉注入时开始给氧):术中氧流量2～3 L/min(Ⅰ组)、3～4 L/min(Ⅲ组)、4～5 L/min(Ⅴ组)。预吸氧组(麻醉前2 min开始给氧2～3 L/min):术中氧流量2～3 L/min(Ⅱ组)、3～4 L/min(Ⅳ组)、4～5 L/min(Ⅵ组)。记录受检者术前、预吸氧后、麻醉后2 min、术中、术后的呼吸次数和SpO2。结果麻醉后受检者SpO2出现不同程度的下降,多数在麻醉后2 min内达最低值,此时预吸氧组的SpO2值较未预吸氧组高(P<0.05)。同样,预吸氧组低氧血症的发生率(11/93、8/95、10/91),明显低于未预吸氧组(28/98、25/94、27/95)(P<0.05或P<0.01)。而SpO2水平、低氧血症发生率方面,不同氧流量的预吸氧组间比较和未给预吸氧组间比较无统计学差异。结论预吸氧后鼻导管给氧2～3 L/min是无痛胃镜检查过程中安全、有效、简便的给氧模式。

Oxygen inhalation model during painless gastroscopy

Objective To study the best oxygen inhalation model during painless gastroscopy.Methods Five hundred and sixty-six patients were randomly divided into non pre-oxygen inhalation group(oxygen was supplied at the time of anesthesia),2-3 L/min intra-operative oxygen flow group(group Ⅰ),3-4 L/min intra-operative oxygen flow group(group Ⅲ),4-5 L/min intra-operative oxygen flow group(group Ⅴ).Respiratory rate and SpO2 of the patients were recorded before operation,after re-oxygenation,2 min after anesthesia,intra-and post-operation,respectively and pre-oxygen inhalation group(oxygen-supply begins at 2-3 L/min two minutes before the anethesia): 2-3 L/min intra-operative oxygen flow group(group Ⅱ),3-4 L/min intra-operative oxygen flow group(group Ⅳ),4-5 L/min intra-operative oxygen flow group(group Ⅵ).Results The SpO2 of patients was differently decreased after anesthesia and reached its lowest value 2 min after anesthesia.The SpO2 was higher in pre-oxygen inhalation group than in non pre-oxygenation group(P<0.05).The incidence of hypoxemia was significantly lower in pre-oxygenation group than in non pre-oxygen inhalation group(11/93,8/95 and 10/91 vs 28/98,25/94 and 27/95,P<0.05 or P<0.01).However,no significant difference was observed in SpO2 and incidence of hypoxemia in pre-oxygen inhalation group and non pre-oxygenation group receiving oxygen flow at different speeds.Conclusion Oxygen inhalation through a nasal tube at a speed of 2-3 L/min during painless gastroscopy is a safe,effective,and simple procedure for oxygen supply.