吸氧在眼科局麻手术中应用的效果观察

Observation on effect of inhaling oxygen in patients of local anesthesia during operation of ophthalmic surgery

目的了解吸氧在眼科局部麻醉手术病人围手术期的应用效果,探讨提高局麻病人手术安全性的方法。方法对本院局麻下行玻璃体切割手术的病人随机分为2组,实验组43例在手术开始时即持续给予2L/min氧气吸入至手术结束,对照组25例手术中未给予氧气吸入。2组均于手术开始时监测血氧饱和度、心率并记录;手术中每5分钟连续监测病人的血氧饱和度、心率;手术结束时监测病人的血氧饱和度、心率并记录。结果实验组与对照组病人血氧饱和度在手术开始时比较无统计学意义（P〉0.05）,手术中、手术末比较有非常显著性意义（P〈0.01）。实验组组内血氧饱和度手术中、手术末与开始分别比较均有非常显著性意义（P〈0.01）,手术中与手术末比较无统计学意义（P〉0.05）。对照组组内血氧饱和度手术开始与手术中比较具有显著性意义（P〈0.05）,手术开始与手术末比较具有显著性意义（P〈0.01）,手术中与手术末比较无统计学意义（P〉0.05）。2组病人手术中各时段心率变化无统计学意义（P〉0.05）。结论吸氧可以使眼科局麻手术病人围手术期血氧饱和度维持在较高水平,明显改善病人的憋闷、烦躁等症状,促进手术顺利进行,提高手术安全性。

Objective To study the effect of inhaling oxygen in the patients of local anesthesia during peri-operation for ophthalmic surgery,and probe into the ways of improving the safety of operation of ophthalmic surgery.Methods There were 68 patients who would be operated on in the way of vitrectomy in this study,and were divided into an experiment group and a control group at random.All the 43 cases in the experiment group were inhaled oxygen（2L/Min）from the beginning to the end of operation.The others（totaling 25 patients）didn＇t inhale oxygen during the process of operation,referred as the control group.For them,the blood oxygen saturation of artery blood of finger and the heart rate were tested at the beginning of operation.Besides this,the blood oxygen saturation and the heart rate were tested every 5 minutes and at the end of operation among all the patients.Results As to the blood oxygen saturation,there was no significant difference between the experimental cases and the control cases（P〉0.05）at the beginning of operation.But there was a significant difference between them in the process and at the end of operation（P〈0.01）.For the control group,there was a significant difference in the blood oxygen saturation between the midst or the end of operation and the beginning of the operation;but,for the experiment group,there was no significant difference in the blood oxygen saturation between the midst and beginning of operation.There was significant difference in the blood oxygen saturation between the midst and the beginning of operation,and there is not significant difference in it between the midst and the end of operation in the control group.There is not significant difference in heart rate between all the stages in two groups.Conclusions Inhaling oxygen can maintain the blood oxygen saturation at a higher level,and improve the syndrome of anoxia.Therefore,it makes the process of operation go smoothly and improves the safety of operation.