药物诱导睡眠内镜检查中低氧血症的干预措施研究

The interventions effects of drug-induced sedation endoscopy on hypoxemia

目的比较不同干预方法对药物诱导睡眠内镜检查中低氧血症矫治的效果。方法选择2019年8月至2020年12月行药物诱导睡眠内镜检查患者60例,随机分为托下颌干预组(T组)30例和鼻咽通气道干预组(B组)30例,采用右美托咪定复合丙泊酚进行药物诱导实施模拟睡眠,当监测患者SPO_(2)<90%时,且持续30 s以上时,进行气道干预,必要时氧气吸入,必要时再辅以面罩加压给氧。当SPO_(2)>95%且持续时间>1 min时停止干预,记录2组干预次数,干预有效所用时间,被迫吸氧次数,面罩加压给氧次数,术中最低SPO_(2)数值以及相应时间点患者的BIS数值。结果2组患者DISE检查结果比较,差异无统计学意义(P>0.05)。T组干预次数为(3.5±1.4)次,B组干预次数为(3.3±1.5)次,2组差异无统计学意义(P>0.05)。干预有效所用时间:T组时间为(51±1.2)s,B组时间为(38±1.6)s,2组比较差异有统计学意义(P<0.05)。被迫吸氧次数比较:T组吸氧次数为(2.1±0.5)次,B组吸氧次数为(1.2±0.3)次,2组比较差异有统计学意义(P<0.05)。术中最低SPO_(2)数值T组为(71.6±7.9),B组为(78.7±8.8),2组比较差异无统计学意义(P>0.05)。T组采取的措施更多,追加吸氧及面罩加压给氧例数均高于B组,差异有统计学意义(P<0.05)。结论两种干预方法均可纠正药物诱导睡眠内镜检查中低氧血症,但鼻咽通气道效果更好,效率更高,推荐用于药物诱导睡眠内镜检查,值得推广。

Objective To investigate the effects of different intervention methods in correcting hypoxemia during drug-induced sedation endoscopy(DISE).Methods Sixty patients with snoring who were scheduled for elective DISE were randomly divided into group T and group B,with 30 cases in each group.The patients in group T were treated by holding submaxilla intervention,and the patients in group B were treated by nasopharyngeal airway intervention.Moreover dexmedetomidine and propofol were infused to produce a state closely resembling physiological sleep.When SpO_(2) was below 90%,sustaining for more than 30 seconds,airway interventions was performed,with face mask ventilations and oxygen breathing.When SpO_(2) was higher than 95%for at least 1 minute,the intervention was stopped.The intervention frequency,and the times of face mask ventilations and oxygen breathing,the minimum SPO_(2) values during operation and BIS value were observed and compared between the two groups.Results There were no significant differences in the results of DISE and intervention frequency between the two groups(P>0.05).However there were significant differences in the intervention effeetive times and oxygen breathing times between the two groups(P<0.05).There were no significant differences in the minumum values of SpO_(2) during operation between the two groups(P>0.05).Moreover,the cases requiring face mask ventilation and oxygen breathing in group T were significantly more than those in group B(P<0.05).Conclusion Both interventin methods can correct hypoxemia during DISE,however,the nasopharyngeal airway can obtain better efficacy,therefor,which is worthy of promotion in clinical practice.