内镜面罩应用加预吸氧在老年患者行无痛胃镜检查中的效果观察

Effects of endoscopic mask and preoxygenation on painless gastroscopy in elderly patients

目的评价内镜面罩应用加预吸氧在老年患者无痛胃镜术的应用效果。方法将行无痛胃镜术的100例老年患者随机分为鼻导管吸氧组(A组)和内镜面罩应用加预吸氧组(B组)。A组患者鼻导管吸氧,氧流量3 L/min;B组患者内镜面罩下预吸氧2 min,氧流量3 L/min。在内镜面罩下行胃镜检查,两组均以异丙酚静脉注射,脉搏血氧饱和度(SpO_2)低于90%视为呼吸抑制。分别于检查前、检查中、检查后记录两组的平均动脉压(MAP)、心率(HR)、和脉搏血氧饱和度(SpO_2),并记录检查时间和不良反应。结果检查中两组患者MAP及鼻导管吸氧组的SpO_2较检查前均明显下降,差异有统计学意义(P<0.05)。两组患者检查中的SpO_2存在显著差异,A组的SpO_2显著低于B组。此外,A组的检查时间及出现的不良反应也显著大于B组(P<0.05)。结论内镜面罩应用加预吸氧用于老年人无痛胃镜术,可增加老年患者体内氧含量、氧储备及机体对缺氧的耐受能力,稳定循环呼吸功能,具有更好的安全性。

Objective To evaluate the effects of endoscopic mask and preoxygenation on painless gastroscopy in elderly patients. Methods One hundred elderly patients with painless gastroscopy were randomly divided into group A and group B. In group A, patients were treated with 3 L/min nasal catheter oxygen. In group B, patients were managed with 3 L/min endoscopic mask oxygen after 2 L/min preoxygenation. Two groups were anesthetized with intravenous injection of propofol. Pulse oxygen saturation （SpO2） lower than 90% was considered as respiratory depression. Mean arterial pressure （MAP） , heart rate （HR） and SpO2 were recorded in two groups before and after gastroscopy. The operation time and adverse reaction were also recorded. Results MAP in two groups and SpO2 in group A significantly decreased during gastroscopy （P〈 0.05）. During operation, there were significant differences in SpO2 between two groups. SpO2 in group A was significantly lower than that in groups B. In addition, the operation time was significantly loger and incidence of adverse reactions was were significantly higher in group A than in group B （P〈0.05）. Conclusions Endoscopic mask and preoxygenation is safe and effective in elderly patients undergoing painless gastroscopy, which increases oxygen content and body＇s tolerance under hypoxia, and stabilizes circulo-respiration function.