自制简易面罩在无痛纤维支气管镜检查中的应用

The application of self-made simple mask in painless fiberoptic bronchoscopy

背景:如何在有效改善气道管理的同时,通过简单有效的方法提高氧供成为配合纤维支气管镜医师操作的关键点。目的:观察自制简易面罩在无痛支气管镜检查过程中应用的临床疗效。方法:纳入无痛纤维支气管镜诊疗患者60例,其中男32例,女28例,年龄(57.8±10.9)岁,采用随机数字表法均分为2组,试验组在无痛纤维支气管镜诊疗中采用自制简易面罩给氧,对照组在无痛纤维支气管镜诊疗中采用喉罩给氧,在纤维支气管镜检查前、插镜过声门、活检或操作时及检查完成时检测患者血氧饱和度、平均动脉压及心率,同时记录不良反应事件。结果与结论:两组患者均顺利完成纤维支气管镜检查,两组组内不同时间点的血氧饱和度、平均动脉压及心率基本稳定,差异不大(P>0.05),并且两组间各指标比较差异也无显著性意义(P>0.05)。试验组中1例发生呛咳,麻醉医师托起下颌后改善;对照组7例出现咽喉部疼痛不适,予以对症处理后缓解,试验组不良反应事件低于对照组(P<0.05)。说明采用简易自制面罩可以有效提供操作过程中的氧供,同时减少采用喉罩操作对患者咽喉部造成的不适。

BACKGROUND： How to effectively improve the airway management and improve oxygen supply at the same time through a simple and effective method becomes an operation key for physicians in fiberoptic bronchoscopy OBJECTIVE： To observe the clinical effect of self-made simple masks in painless fiberoptic bronchoscopy. METHODS： A total of 60 patients receiving painless fiberoptic bronchoscopy, 32 males and 28 females, with a mean age of （57.8＋10.9） years were randomized into two groups： test group with self-made simple mask during painless fiberoptic bronchoscopy and control group with laryngeal mask. In the course of examination, the changes of oxygen saturation, mean arterial pressure and heart rate were observed at different time points. And adverse events of both groups were also recorded. RESULTS AND CONCLUSION： Patients from both groups successfully completed fibre bronchoscopy. The oxygen saturation, mean arterial pressure and heart rate in the two groups were not significantly different （P 〉 0.05）. However, the test group （one case of bucking） was superior to the control group （seven cases of sore throat） in terms of adverse events （P 〈 0.05）. The simple mask can improve the oxygen supply and reduce the adverse events.