快充式经鼻湿化高流量通气与鼻导管纯吸氧对肥胖无痛胃镜受检者血流动力学指标及不良事件发生率的影响

Influence of transnasal humidified rapid-insufflation high-flow ventilation and nasal catheter pure oxygen inhalation on hemodynamic indicators and incidence rates of adverse events in obese subjects undergoing painless gastroscopy

目的:观察快充式经鼻湿化高流量通气与鼻导管纯吸氧对肥胖无痛胃镜受检者血流动力学指标及不良事件发生率的影响。方法:选用2021年3月~2023年3月南城县人民医院接收的68例肥胖无痛胃镜受检者作为研究对象,依照区组随机化分组法将其分为纯吸氧组和高流量通气组,各34例。纯吸氧组受检时接受鼻导管纯吸氧,高流量通气组受检时接受快充式经鼻湿化高流量通气。对比麻醉期间两组血流动力学指标,比较两组胃镜检测情况(胃镜检查时间、麻醉苏醒时间、离院时间),统计两组不良反应及不良事件发生率。结果:麻醉时、胃镜检查时、胃镜检查5min,两组平均动脉压、心率均无明显差异(P>0.05),检查结束时,高流量通气组平均动脉压、心率均明显低于纯吸氧组(P<0.05)。两组麻醉苏醒时间无明显差异(P>0.05),高流量通气组胃镜检查时间、离院时间均明显低于纯吸氧组(P<0.05)。检查期间,两组不良反应无明显差异(P>0.05),高流量通气组不良事件总发生率明显低于纯吸氧组(P<0.05)。结论:对肥胖无痛胃镜受检者实施快充式经鼻湿化高流量通气,可有效维持其血流动力学稳定,还能减少无痛胃镜检查时间,预防不良事件的发生,值得临床应用推广。

Objective:To observe the influence of transnasal humidified rapid-insufflation high-flow ventilation and nasal catheter pure oxygen inhalation on hemodynamic indicators and incidence rates of adverse events in subjects with obesity undergoing painless gastroscopy.Methods:A total of 68 obese subjects with painless gastroscopy who were received by Nancheng County People’s Hospital were selected from March 2021 to March 2023 as the research subjects.According to the block randomization grouping method,they were divided into pure oxygen inhalation group(34 cases)and high-flow ventilation group(34 cases).The pure oxygen inhalation group received nasal catheter pure oxygen inhalation,while the high-flow ventilation group was given transnasal humidified rapid-insufflation high-flow ventilation.The hemodynamic indicators during anesthesia and gastroscopy examination(gastroscopy time,anesthesia recovery time,discharge time)were compared,and the incidence rates of adverse reactions and adverse events were counted.Results:There were no statistical differences in mean arterial pressure and heart rate between the two groups during anesthesia,during gastroscopy and during 5 min of gastroscopy(P>0.05).At the end of the examination,the mean arterial pressure and heart rate in high-flow ventilation group were lower than those in pure oxygen inhalation group(P<0.05).There was no statistical significance in anesthesia recovery time between the two groups(P>0.05).The gastroscopy time and discharge time were shorter in high-flow ventilation group than those in pure oxygen inhalation group(P<0.05).There were no statistically significant differences in adverse reactions between the two groups during the examination(P>0.05).The total incidence rate of adverse events in high-flow ventilation group was significantly lower compared with that in pure oxygen inhalation group(P<0.05).Conclusion:Transnasal humidified rapid-insufflation high-flow ventilation can effectively maintain the hemodynamic stability,shorten the painless gastroscopy time,and prevent the occurrence of adverse events in obese patients undergoing painless gastroscopy.