组合鼻咽通气管联合MJV在高龄患者无痛支气管镜中的应用

Application of Combination Nasopharyngeal Ventilation Tube and Manual Jet Ventilation in Painless Bronchoscopy in Elderly Patients

目的:探讨组合鼻咽通气管联合手控喷射通气(manual jet ventilation,MJV)在高龄患者无痛支气管镜中应用效果和安全性。方法:选取2017年3月-2018年4月本院全麻下行无痛支气管镜检查的高龄患者64例行前瞻性、对比性研究,按照随机数字表法将患者分为干预组和对照组,各32例。干预组采用组合鼻咽通气管联合MJV持续给氧,对照组采用普通鼻导管经鼻咽通气管持续给氧4 L/min。比较两组患者收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO_2)变异情况以及不良反应发生率、舒适度。结果:干预组患者SBP、DBP、HR、SpO_2变异性均低于对照组,差异均有统计学意义(P<0.05)。干预组患者呛咳、体动发生率分别为6.25%、3.13%,均低于对照组的25.00%、21.98%,差异均有统计学意义(P<0.05)。干预组患者舒适度为81.25%,高于对照组的50.00%,差异有统计学意义(P<0.05)。结论:组合鼻咽通气管联合MJV在高龄患者无痛支气管镜中应用,能有效维持患者血流动力学、心率稳定,降低并发症发生率,提高患者舒适度。

Objective:To explore the efficacy and safety of combined nasopharyngeal ventilation and manual jet ventilation(MJV)in painless bronchoscopy in elderly patients.Method:A prospective and comparative study of 64 elderly patients undergoing painless bronchoscopy in our hospital from March 2017 to April 2018 was selected.They were divided into intervention group and control group,follow the random number table method,32 cases in each group.In the intervention group,combined nasopharyngeal airway tubes with MJV were used for continuous oxygen supply.The control group received 4 L/min of oxygenation through the nasopharyngeal airway through the common nasal catheter.The variability of SBP,DBP,HR,SpO2,incidence of adverse reactions and comfort were compared between the two groups.Result:The SBP,DBP,HR,SpO2 variability in the intervention group were lower than those in the control group,the differences were statistically significant(P<0.05).In the intervention group,the incidence of chock activity was 6.25%,3.13%,respectively,lower than 25.00%and 21.98%of the control group,the differences were statistically significant(P<0.05).The comfort level of the intervention group was 81.25%,which was higher than 50.00%of the control group,the difference was statistically significant(P<0.05).Conclusion:The combination of nasopharyngeal ventilation tube and MJV in the painless bronchoscopy of elderly patients can effectively maintain the patient’s hemodynamics,heart rate stability,reduce the incidence of complications and improve patient comfort.