口咽通气管在无痛肠镜检查的临床应用

Oropharynx Airway in the Clinical Application of Endoscopic Check Painlessly

目的探讨放置口咽通气管在静脉全身麻醉下结肠镜检查(无痛肠镜)的临床应用。方法 300例无痛肠镜患者随机分为两组,159例患者(观察组)以丙泊酚复合芬太尼静脉麻醉后经口放置口咽通气管面罩吸氧下行无痛肠镜检查,对同期141例患者(对照组)采取同样麻醉手术方法但不放置口咽通气管。观察和记录两组患者麻醉手术过程中的麻醉效果、主要反应性症状,包括人体动、鼾声呼吸、呼吸困难(一过性血氧饱和度下降至90%需采取托下颌或人工辅助吸氧处理)及各时段的心率、血氧饱和度等主要生命体征变化情况。结果两组患者一般资料、麻醉效果比较无差异;术中观察组和对照组分别有19例和20例轻微体动;观察组没有病例出现鼾声呼吸,仅有5例出现一过性呼吸困难,对照组有38例出现鼾声呼吸,27例出现一过性呼吸困难,两组间比较有统计学意义(P<0.01);两组全过程麻醉前、操作中、苏醒后患者无任何不适感觉,两组此时段HR、SpO2比较没有统计学意义(P>0.05),对照组在给药后2min的SpO2比观察组低,两组比较有统计学意义(P<0.01)。结论放置口咽通气管能有效缓解无痛肠镜检查中静脉麻醉所致舌后坠引起的上呼吸道梗阻,保持良好通气,提高安全性。

Objective Explore placed oropharynx airway under general anesthesia in vein endoscopic check（painless colonoscopy） clinical application.Methods 300 cases painless colonoscopy patients were randomLy divided into two groups,159 patients（the observation group） with acryloxyethyl poisson phenolic compound fentanyl after intravenous anesthesia by mouth placed oropharynx airway mask oxygen endoscopic check for downlink painless,same 141 patients（control group） anesthesia to take a similar approach but not placed oropharyngeal ventilation tube.Observing and recording two groups of patients in the process of anesthesia anaesthetic effect,the main reaction symptoms,including human move,snoring breathing,difficulty breathing（a blood oxygen desaturation sex should be taken to 90% benito jaw or artificial auxiliary oxygen treatment） and each period of heart rate,blood oxygen saturation and other major changes vital signs.Results Two groups of patients generally material,anesthesia effect is no difference;intraoperative trial group and control group there were 19 and 20 cases of mild body move;the observation group without snoring breathing cases,only five were appeared transient difficulty breathing,group compared with 38 cases,snoring breathing 27 cases occurred sex difficulty breathing,compared between the two groups was statistically significant（P0.01）;two groups before and operation process anesthesia,without any discomfort awoke patients feel,two groups SpO2 compare this section HR,no statistically significant（P0.05）,and the control group after the treatment of 2min in SpO2 than the observation group low,two groups of comparisons are statistically significant（P0.01）.Conclusion Placed oropharynx airway can effectively relieve painless in endoscopic check after intravenous anesthesia caused by falling tongue upper respiratory tract obstruction,maintain good ventilation,improve the safety.