快充式经鼻湿化高流量通气在肥胖患者无痛胃镜检查中的应用效果

Application effect of fast filling nasal humidification high flow ventilation on obese patients underwent painless gastroscopy

摘要:

目的 比较鼻导管纯吸氧和快充式经鼻湿化高流量通气在肥胖患者无痛胃镜检查中的应用效果。方法 选取2019年1月－2021年1月该院行无痛胃镜检查的118例患者作为研究对象，所有患者体重指数（BMI）≥ 28 kg/m²，采用随机数表法将其分为两组，各59例。观察组和对照组分别给予快充式经鼻湿化高流量通气和鼻导管纯吸氧。比较两组患者无痛胃镜检查麻醉前（T₀）、麻醉5 min（T₁）、苏醒5 min（T₂）的血流动力学水平、无痛胃镜检查情况、缺氧相关不良事件及干预情况、不良反应和患者满意度。结果 观察组T₁和T₂时点平均动脉压（MAP）和经皮动脉血氧饱和度（SpO₂）高于对照组，心率（HR）低于对照组，观察组T₁时点呼吸频率（RR）高于对照组，差异均有统计学意义（P < 0.05）。观察组检查时间短于对照组，亚临床呼吸抑制和缺氧发生率低于对照组，开放通气、面罩通气和气管内插管机械通气使用率低于对照组，不良反应总发生率低于对照组，观察组对胃镜检查满意度为79.66%，明显高于对照组的57.63%，差异均有统计学意义（P < 0.05）。结论 快充式经鼻湿化高流量通气应用于肥胖患者无痛胃镜检查中，能够稳定患者的血流动力学水平，缩短检查时间，提高检查成功率，减少缺氧相关不良事件，降低不良反应发生率，提高患者的检查满意度。

Abstract:

Objective To compare the application effects of pure oxygen inhalation through nasal catheter and fast filling transnasal humidification high flow ventilation in painless gastroscopy of obese patients.Methods 118 patients who came to our hospital for painless gastroscopy from January 2019 to January 2021 were selected as the research objects. All the patients with body mass index (BMI) ≥ 28 kg/m², they were divided into two groups by random number table method, 59 cases in each group. The observation group and the control group were given fast filling transnasal humidification high flow ventilation and nasal catheter pure oxygen inhalation. Compare the hemodynamic index levels of painless gastroscopy before anesthesia (T₀), anesthesia 5 min (T₁), and awake 5 min (T₂), compare painless gastroscopy, hypoxia-related adverse events and interventions, adverse reactions and patients’ gastroscopy satisfaction rate.Results At T₁ and T₂, the mean arterial pressure (MAP) and percutaneous arterial oxygen saturation (SpO₂) of the observation group was higher than that of the control group, and the heart rate (HR) was lower than that of the control group; At T₁, the respiratory rate (RR) of the observation group was higher than those of the control group, the differences were significant (P < 0.05). The inspection time of the observation group was shorter than that of the control group, the incidence of subclinical respiratory depression, hypoxia and the use rate of open ventilation, face mask ventilation and endotracheal intubation mechanical ventilation were lower than those of control group, the total incidence of adverse reactions was lower than that of control group, the patients’ satisfaction was 79.66%, there was significant higher than that of the control group (57.63%), and the differences were significant (P < 0.05).Conclusion Fast filling transnasal humidification high flow ventilation is used in obese patients undergoing painless gastroscopy, which can effectively improve the patient’s hemodynamics, shorten the examination time, increase the success rate of the examination, reduce the adverse events and adverse reactions related to hypoxia incidence rate of the disease, and improve the patient’s satisfaction with the examination.