表面麻醉下不同吸氧方式对白内障超声乳化手术成年患者手术期生命体征变化的影响

Effects of different oxygen inhalation methods on the changes of vital signs in adult patients undergoing phacoemulsification under topical anesthesia

目的:观察表面麻醉下不同吸氧方式对白内障超声乳化手术患者生命体征变化的影响,探讨适宜的超声乳化手术中吸氧的方式。方法:选取2020年4月至2020年9月于中山大学中山眼科中心行白内障超声乳化摘除术的患者291例,随机分成3组,分别为简易面罩吸氧组(面罩组)97例、鼻导管吸氧(鼻导管组)97例、无吸氧组(对照组)97例,其中面罩组和鼻导管组的吸氧流量均为氧流量2~4 L/min。监测患者进入手术室时(T_(0))、手术开始时(T_(1))以及手术结束时(T_(2))的血压、心率以及血氧饱和度(SpO_(2))。结果:三组患者在进入手术间时生命体征差异无统计学意义,三组患者术中血压变化不显著(P>0.05)。在T_(2)时点,氧气吸入的患者其SpO_(2)高于对照组(P<0.05),但均在正常范围内。结论:表面麻醉下白内障超声乳化手术的患者在无严重基础疾病的情况下,术中适当吸氧及监测血流动力学可以增加患者的舒适度及临床安全,对患者使用的吸氧方式应以不影响术中操作及患者舒适度的方式。

Objective:To observe the effects of different oxygen inhalation methods on the changes of vital signs in adult patients undergoing phacoemulsification under topical anesthesia,and to explore the appropriate oxygen inhalation methods in phacoemulsification.Methods:A total of 291 patients who underwent phacoemulsification for cataract extraction in Zhongshan Ophthalmic Center,Sun Yat-sen University from April 2020 to September 2020 were randomly divided into 3 groups:the simple mask oxygen inhalation group(n=97),the nasal catheter oxygen inhalation group(n=97),and the oxygen-free group(n=97).The oxygen flow of the mask group and the nasal catheter group was 2-4 L/min.Blood pressure,heart rate,and oxygen saturation(SpO_(2))were monitored at entry into the operating room(T_(0)),at the beginning of surgery(T_(1)),and at the end of surgery(T_(2)).Results:There was no significant difference in vital signs among the 3 groups when entering the operating room,and no significant change in intraoperative blood pressure among the 3 groups(P>0.05).At T_(2),the blood oxygen saturation of patients with oxygen inhalation was higher than that of the oxygen-free group(P<0.05),but within the normal range.Conclusion:For cataract phacoemulsification patients under topical anesthesia without serious comorbidities,appropriate oxygen inhalation and monitoring hemodynamics can increase the comfort and safety of patients,and oxygen inhalation should be used without affecting surgery manipulation and comfort of patient.