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[1]肖悦,曹雅男,毛畅远,等.经鼻高流量湿化氧疗在宫腔镜手术患者全凭静脉麻醉中的应用[J].医学研究与战创伤救治(原医学研究生学报),2022,24(6):620-624.[doi:10.3969/j.issn.1672-271X.2022.06.012]
　XIAO Yue,CAO Ya-nan,MAO Chang-yuan,et al.Application of humidified high flow nasal cannula oxygen therapy in total intravenous anesthesia for patients undergoing gynecological hysteroscopy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(6):620-624.[doi:10.3969/j.issn.1672-271X.2022.06.012]
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经鼻高流量湿化氧疗在宫腔镜手术患者全凭静脉麻醉中的应用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年6期
页码:
620-624
栏目:
临床研究
出版日期:
2023-01-18

文章信息/Info

Title:
Application of humidified high flow nasal cannula oxygen therapy in total intravenous anesthesia for patients undergoing gynecological hysteroscopy
作者:
肖悦; 曹雅男; 毛畅远; 段文斌; 胡益民
作者单位：213003常州，南京医科大学附属常州市第二人民医院麻醉科（肖悦、段文斌、胡益民）；213003常州，蚌埠医学院常州临床医学院麻醉科（曹雅男、毛畅远）
Author(s):
XIAO Yue1;  CAO Ya-nan2;  MAO Chang-yuan2;  DUAN Wen-bin1;  HU Yi-min1
(1.Department of Anesthesiology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu, China; 2.Department of Anesthesiology, The Affiliated Changzhou No.2 People’s Hospital of Bengbu Medical College, Changzhou 213003, Jiangsu, China)
关键词:
经鼻高流量湿化氧疗; 宫腔镜检查; 全凭静脉麻醉; 丙泊酚
Keywords:
humidified high flow nasal cannula oxygen therapy;  gynecological hysteroscopy;  total intravenous anesthesia;  propofol
分类号:
R614
DOI:
10.3969/j.issn.1672-271X.2022.06.012
文献标志码:
A
摘要:
目的比较经鼻高流量湿化氧疗（HFNC）与传统鼻导管吸氧模式对丙泊酚复合舒芬太尼全凭静脉麻醉下行宫腔镜手术患者手术期间氧合的影响。方法选择择期行宫腔镜手术患者60例，采用随机数字表法将患者分为HFNC组和对照组，每组30例。每组患者均采用丙泊酚复合舒芬太尼全凭静脉不插管麻醉的方法，HFNC组采用经鼻高流量湿化氧疗，对照组采用传统鼻导管吸氧。记录患者的一般情况、手术期间的生命体征、动脉二氧化碳分压（PaCO2）、动脉氧分压（PaO2）、氧合情况、麻醉药物的使用量、手术时间以及患者的满意度，比较2组患者手术期间SpO2＜95%、气道干预和因体动导致手术中断的发生率。结果各组患者的一般情况、手术时间和舒芬用量的比较差异均无统计学意义（P>0.05）；与对照组相比，HFNC组丙泊酚用量显著增加[（185.5±30.2)mg vs (208.5±28.7)mg,P<0.05）]，手术结束即刻PaO2也显著升高[（171.4±91.3)mmHg vs (304.3±126.4)mmHg,P<0.05）]，但PaCO2差异无统计学意义（P>0.05）； 在手术过程中，SpO2<95%的发生率（26.7% vs 53.5%,P<0.05），手术中断发生率（6.7% vs 43.4%,P<0.05）以及因为气道保护行托下颌（26.7% vs 53.5%,P<0.05）及面罩给氧的发生率（3.3% vs 20%,P<0.05），HFNC组明显低于对照组（P<0.05）。结论在丙泊酚联合舒芬太尼全凭静脉非插管麻醉下行经宫腔镜手术期间，使用HFNC可以为患者提供更好的氧合，降低术中低氧血症的发生率，减少气道干预的次数，为患者带来更好的氧供保证，提高手术麻醉的安全性。
Abstract:
ObjectiveThis study aims to investigate the clinical practice of humidified high flow nasal cannula in total intravenous anesthesia with propofol plus sufentanil for patients undergoing gynecological hysteroscopy .MethodsA total of 60 female patients（ASAⅠ-Ⅱ, age 18-60 years） undergoing gynecological hysteroscopy were divided into HFNC group (H group, n=30) and control group (C group, n=30) using random number table method. Patients in each group were treated with the same propofol plus sufentanil by intravenous anesthesia. The H group and C group was accepted oxygen supply with HFNC and traditional nasal catheter respectively. The patient’s general condition, vital signs during surgery, the arterial blood gas including PaCO2 and PaO2 before and after the surgery, oxygenation, anesthetic dosage, operation time, and patient satisfaction were recorded. The incidence of SpO2<95%, airway interventions and body-movements during the procedures were compared between the two groups.ResultsThe general condition, operation duration time and the sufentanil consumption showed on difference between the two groups, but the propofol consumption was more[(185.5±30.2)mg vs 9208.5±28.7)mg, P<0.05)] and the PaO2 was higher[(171.4±91.3)mmHg vs (304.3±126.4)mmHg, P<0.05)] after the surgery in group H (P<0.05), but there was no difference in the PaCO2 after the surgery between the two groups. During the procedure, the incidence of SpO2<95% (26.7% vs 53.5%, P<0.05, the incidence of surgical interruption (6.7% vs 43.4%, P<0.05), airway interventions (26.7% vs 53.5%, P<0.05) and the surgical interruption (3.3% vs 20%, P<0.05) due to the body-movements in H group were significantly lower than those in C group (P<0.05).ConclusionDuring the total intravenous anesthesia with propofol plus sufentanil for patients undergoing gynecological hysteroscopy, the application of humidified high flow nasal cannula can achieve better oxygenation and airway management with low incidence of hypoxemia and airway interventions during the procedure，providing a better and safer environment for patients and improving the safety of anesthesia.

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备注/Memo

备注/Memo:
基金项目：常州市科技计划资助项目（CJ20210112）
更新日期/Last Update: 2023-01-18