经鼻高流量湿化氧疗与高频通气对行无痛支气管镜检查术患者血气指标的影响

Influence of nasal high-flow humidification oxygen therapy and high-frequency ventilation on the blood gas indicators of patients undergoing painless bronchoscopy

摘要:

目的 分析经鼻高流量湿化氧疗（HFNC）与高频通气对无痛支气管镜检查术患者血气指标的影响。方法 选取2024年2月－2024年10月该院收治的，并行无痛支气管镜检查术的患者130例，依据随机数表法分为3组。其中，A组（43例）行HFNC治疗，B组（43例）行高频通气治疗，对照组（44例）行经鼻持续正压通气治疗。比较3组患者支气管镜检查前（T₀）、支气管镜进入气管分叉时（T₁）、检查结束时（T₂）、检查结束后30 min（T₃）和检查结束后2 h（T₄）的生命体征和血气分析指标；比较3组患者不良反应发生率和镜检满意度。结果 3组患者心率（HR）、呼吸频率（RR）、平均动脉压（MAP）和动脉血二氧化碳分压（PaCO₂）的时间、交互和组间效应比较，差异均有统计学意义（P < 0.05），3组患者动脉血氧分压（PaO₂）的时间和交互效应比较，差异均有统计学意义（P < 0.05），组间效应比较，差异无统计学意义（P > 0.05）。与T₀时点相比，A组和B组T₁、T₂和T₃时点的HR、RR、MAP、PaO₂和PaCO₂明显升高，差异均有统计学意义（P < 0.05），pH值无明显变化（P > 0.05）；T₁和T₂时点，B组HR、RR、MAP、PaO₂和PaCO₂水平明显高于A组和对照组，差异均有统计学意义（P < 0.05）；T₃时点，A组HR、RR、MAP、PaO₂和PaCO₂水平明显高于B组和对照组，且B组RR、PaO₂和PaCO₂明显高于对照组，差异均有统计学意义（P < 0.05）；T₄时点，3组患者HR、RR、MAP、PaO₂、PaCO₂和pH值均恢复至T₀时点。A组不良反应总发生率为2.33%，明显低于B组的16.28%和对照组的22.73%，A组镜检满意度为95.35%，明显高于B组的81.40%和对照组的65.91%，差异均有统计学意义（P < 0.05）。结论 相比于传统经鼻持续正压通气治疗，HFNC和高频通气对行无痛支气管镜检术患者的血气分析指标均有改善作用，且HFNC比高频通气改善效果更好，不良反应总发生率更低，镜检满意度更好。

Abstract:

Objective To analyze the effects of nasal high-flow humidification oxygen therapy (HFNC) and high-frequency ventilation on blood gas indicators in painless bronchoscopy.Methods 130 patients who underwent painless bronchoscopy from February 2024 to October 2024 were selected and divided into 3 groups according to the random number table method. Among them, group A (43 cases) was treated with HFNC, group B (43 cases) received high-frequency ventilation treatment, and the control group (44 cases) received continuous positive nasal pressure ventilation treatment. Compare three groups of patients before bronchoscopy (T₀), bronchoscope into the tracheal bifurcation (T₁), at the end of the examination (T₂), 30 minutes after the examination (T₃), and 2 hours after the examination (T₄) the vital signs and blood gas index; Compare the incidence of adverse reactions and the satisfaction of microscopic examination among the three groups of patients.Results The time, interaction and inter group effect of heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), and arterial partial pressure of carbon dioxide (PaCO₂) in the three groups were statistically significant (P < 0.05). The time and interaction of and arterial partial pressure of oxygen (PaO₂) in the three groups were statistically significant (P < 0.05), there was no significant difference in inter group effect (P > 0.05). Compared with T₀, HR, RR, MAP, PaO₂ and PaCO₂ of group A and group B at T₁, T₂ and T₃ were significantly higher (P < 0.05), and there was no significant change in pH value (P > 0.05); At time points T₁ and T₂, the levels of HR, RR, MAP, PaO₂, and PaCO₂ in group B were significantly higher than those in group A and the control group, and the differences were statistically significant (P < 0.05); At time point T₃, the levels of HR, RR, MAP, PaO₂ and PaCO₂ in group A were significantly higher than those in group B and the control group, and the RR, PaO₂ and PaCO₂ of group B were significantly higher than those of the control group, with the differences were statistically significant (P < 0.05); At the T₄ time point, HR, RR, MAP, PaO₂, PaCO₂ and pH value of the three groups all recovered to the T₀ time point. Incidence of adverse reaction of group A 2.33% was lower than that in group B, which was 16.28% and 22.73% in the control group, group A microscopic examination satisfaction was 95.35%, which was significantly higher than group B 81.40% and the control group 65.91%, the differences were statistically significant (P < 0.05).Conclusion Compared with traditional nasal continuous positive pressure ventilation treatment, both HFNC and high-frequency ventilation have an improving effect on blood gas indicators in painless bronchoscopy. Moreover, HFNC has a better improvement effect than high-frequency ventilation, a lower total incidence of adverse reactions, and a higher satisfaction rate in bronchoscopy.