幼年型复发性呼吸道乳头状瘤围手术期夜间指脉氧监测情况

Monitoring of finger pulse oxygen during perioperative period of juvenile recurrent respiratory papilloma

目的探讨幼年型复发性呼吸道乳头状瘤病(juvenile onset recurrent respiratory papillomatosis,JORRP)患儿围手术期夜间指脉氧监测变化。方法对34例JORRP患儿在术前和术后分别行夜间指脉氧监测,分析影响血氧饱和度的因素。结果术前符合低氧血症者为82.4%(28/34),一度呼吸困难者平均血氧饱和度(mean oxygen saturation,MSpO_(2))和最低血氧饱和度(lowest oxygen saturation,LSpO_(2))均高于二度呼吸困难患儿。一度呼吸困难患儿的平均3%氧减指数(oxygen desaturation index,ODI)[(1.09±0.79)次/h]显著低于二度呼吸困难患儿[(2.76±2.91)次/h]。患儿术后当晚的夜间LSpO_(2)及3% ODI均较术前无统计学意义。结论 JORRP可以导致部分患儿出现喉源性阻塞性睡眠呼吸暂停低通气综合征,其严重程度与呼吸困难严重程度成正比。术后当晚由于局部黏膜肿胀等原因,夜间LSpO_(2)及3%ODI较术前无明显变化,因此术后仍应密切注意患儿呼吸情况。

OBJECTIVE To investigate the changes of monitoring pulse oxygen saturation in children with juvenile onset recurrent respiratory papillomatosis (JORRP) during perioperative period.METHODS Pulse oxygen saturation was performed in 34 JORRP patients at night preoperatively and postoperatively respectively.Then the factors affecting pulse oxygen saturation was analyzed.RESULTS 82.4%(28/34) of the patents were diagnosed with the hypoxemia before treatment.Mean oxygen saturation(MSpO_(2)) and lowest oxygen saturation(LSpO_(2)) were higher in patients with degree I dyspnea compared with degree II dyspnea.The 3% Oxygen desaturation index(ODI) of patients with degree I dyspnea[(1.09±0.79) events/h]was lower than that with degree II dyspnea[(2.76±2.91) events/h](P<0.05).Comparing the LSpO_(2) and 3%ODI on the first night of post-operation to pre-operation,there were no significant differences.CONCLUSION Recurrent respiratory papilloma can cause laryngeal OSAHS in some children,and the severity is positively relative to the degree of dyspnea.The LSpO_(2) and 3%ODI on the first night of post-operation without significant difference compared with pre-operation due to local mucosal swelling or other factors.Therefore,the children’s breathing situation should be closely monitored and given electrocardiograph monitoring on the first night of post-operation.