无痛纤支镜检查术中几种供氧方法及比较

Several kinds of supply oxygen method in painless fiberoptic bronchoscopy and comparison

目的探讨无痛纤支镜检查术中的供氧方法。方法60例病人随机平分为Ⅰ、Ⅱ、Ⅲ组,均在全麻无痛下检查。Ⅰ组经鼻导管供氧,麻醉后自主呼吸(12±2.6)次/分,氧流量4L/分。Ⅱ组经气管插管供氧,快速诱导行气管内插管后,行控制呼吸,纤支镜通过弯接头上的吸痰孔进入气道检查。Ⅲ组经纤支镜供氧,术中自主呼吸(13±3.5)次/分,行紧闭给氧。结果Ⅰ、Ⅱ、Ⅲ组病人术中SpO2分别为(89.3±1.5)%、(97.5±1.5)%、(96.4±1.7)%,Ⅰ组明显低于Ⅱ、Ⅲ组(P<0.05)。Ⅱ、Ⅲ组病人PetCO2分别为(35±3.7)mmHg、(38±3.5)mmHg,均在正常范围内波动。Ⅱ组术后咽部不适明显,恢复时间长。结论Ⅰ组方法安全性差,不能保证供氧。Ⅱ组方法安全性高,但术后并发症较多。Ⅲ组方法供氧满意,操作简单方便,只要注意选择病人,术中安全性仍较满意。

Objective:To study the supply oxygen method in painless fiberoptic bronchoscopy.Methods:60 patients were randomly divided equally into 3 groups,namely group Ⅰ,Ⅱ and Ⅲ,all patients underwent the painless inspection in the general anesthesia.The supply oxyen method in group Ⅰ was adopted by nose pipe,the spontaneous respiration was (12±2.6)times/minute after anesthesia,the oxygen discharge was 4 L/minute.The supply oxygen method in group Ⅱ was adopted by trachea cannula and in group Ⅲby fiberoptic bronchoscope.The intraoperative spontaneous respiration in group Ⅲ was (13±3.5)times/minute,with closed supply oxygen.Results:The intraoperative SpO2 in group Ⅰ,Ⅱ and Ⅲ was (89.3±1.5)%,(97.5±1.5)% and (96.4±1.7)% respectively,which was obviously lower in group Ⅰ than that in group Ⅱ and Ⅲ(P<0.05).The PetCO2 in group Ⅱ and Ⅲ was (35±3.7) mmHg and (38±3.5)mmHg respectively,all were undulation within the normal range.The pharyngeal trouble in group Ⅱ was obvious after operation,recovery time was long.Conclusion:The safety of supply oxygen method in group Ⅰ is bad,which cannot guarantee to supply oxygen.The safety of supply oxygen method in group Ⅱ is high,but the complication is more after operation.The supply oxygen method in group Ⅲ is satisfactory,the procedure is simple and convenient.As long as you pay attention to choose patient,the intraoperative safety is still satisfactory.