摘要
目的 探讨在可曲性纤维支气管镜检查(FFB)中,动脉血氧饱和度减低的原因.方法 经脉搏血氧饱和度仪(简称血氧仪)持续监测336例病人的动脉血氧饱和度(SpO2)并记录,分析SpO2下降与各种临床参数和原有肺疾病的关系.结果 在336例中,86例(22%)有一过性SpO2下降(SpO2＜90%的时间大于10 s),年龄大于75岁者,55%有一过性SpO2下降,低氧血症发生率明显高于年龄低于75岁组(27%)(P＜0.05).与患有其他肺疾病和没有肺疾病者相比较,肺纤维化(ⅡP)组出现SpO2下降的危险性较大(P＜0.05).多因素分析表明,年龄和ⅡP分别是SpO2下降的独立危险因素,而多数病人(94%)不需要常规吸氧.结论 尽管FFB是安全的,而高龄、肺纤维化是发生氧饱和度减低的高危因素.
Objective To examine the causes of arterial oxygen desaturation during FFB.Methods 336 patients who underwent FFB without intervention.Arterial oxygen saturation(SpO2) was continuously monitored using oximetry with a recording system.Analyzed the relationship between a reduction in SpO2 during FFB and various clinical parameters or background lung diseases.Results Of the 336 patients,86(22%) had an episode of oxygen desaturation(SpO2<90% over 10 s).Of patients over 75 years old,55% had an episode of oxygen desaturation,which was significantly higher than 27% observed in the patients less than 75 years old(P< 0.05).Patients with pulmonary fibrosis had a higher risk of desaturation(55%) compared to patients with other complications or patients without any complication(p<0.05).Multivariable analysis revealed that both age and pulmonary fibrosis were independent predictors of oxygen desaturation.However,the majority of the patients(94%) did not require routine oxygen supplementation.Conclusion Although FFB is safe and does not require oxygen supplementation in most cases,age over 75 years and pulmonary fibrosis are high risk factors for significant oxygen desaturation during FFB.
