氢气对无痛纤维支气管镜检查应激反应的研究

Clinical observation of hydrogen gas in reducing stress response in painless fiberoptic bronchoscopy

目的 观察氢气吸入治疗是否能减轻无痛纤维支气管镜检查的应激反应。方法 选取2021年6月至2023年6月南京医科大学附属江宁医院呼吸科ASA分级I~III级择期行无痛纤维支气管镜检查术的患者。分为氢气组和氧气组,分别于无痛纤维支气管镜检查前3天持续鼻导管吸入氢氧混合气体(H_(2)/O_(2):66.6%/33.3%)和低浓度氧气(O2:30%)6 h,观察纤支镜检查20 min内患者呛咳和体动情况,记录麻醉前(T1)、纤支镜达声门即刻(T2)、纤支镜达气管隆突即刻(T3)、检查完毕即刻(T4)、检查完毕10 min(T5)的生命体征(BP、HR、RR、SpO2),比较术中两组的麻醉药用量和不良反应发生率,术后随访两组的检查舒适满意度。结果 氢气组患者纤支镜检查术中呛咳和体动情况明显少于氧气组(P<0.05)。在T2和T3时间点,氢气组MAP、HR和RR上升的均值低于氧气组(P<0.05)。氢气组患者发生咳嗽和体动的次数低于氧气组(P<0.05),丙泊酚用量少于氧气组,拔除喉罩恢复自主呼吸的时间早于氧气组(P<0.05)。氢气吸入组患者检查舒适满意度高于对照组(P<0.05)。结论 氢气吸入辅助治疗可以减轻无痛支气管镜检查患者的术中应激反应。

Objective To observe whether hydrogen inhalation treatment can reduce the stress response of painless fiber optic bronchoscopy.Methods From June 2021 to June 2023 ninety-four patients who underwent selective operation on painless fiber optic bronchoscopy according to ASA classifications were randomly divided into two groups,the Hydrogen inhalation group and the oxygen inhalation group.The patients were respectively administered continuous nasal catheter inhalation of hydrogen and oxygen mixed gas(H_(2)/O_(2):66.6%/33.3%)and low concentration oxygen(O2:30%)for 6 hours,three days before painless fiberoptic bronchoscopy.The cough and movement within 20 mins bronchoscopy,and the vital signs(BP,HR,RR,SpO_(2))before anesthesia(T1),bronchoscopy to the glottis(T2),tracheal carina(T3),completion of exam(T4)and 10 min after exam(T5)were recorded.The amount of anesthetic drugs,incidence of adverse reactions in the two intraoperative groups,andpost-operative follow-up of both groups for comfort satisfaction were compared.Results The cough and movement of patients in the hydrogen inhalation group were significantly lowerthan that of the oxygen inhalation group during painless fiberoptic bronchoscopy.The mean arterial pressure(MAP),heart rate(HR)and respiratory rate(RR)of the hydrogen inhalation group at T2 and T3 werelower than that of the oxygen inhalation group(P<0.05).Compared to the oxygen inhalationgroup,the amount of propofol was less,the recovery time of spontaneous breathing after removingthe laryngeal mask was earlier,and the comfort satisfaction of patients was higher in the hydrogen inhalation group.There were no postoperative adverse effects in both groups.Conclusion Hydrogen inhalation adjuvant therapy can reduce the intraoperative stress response in patients undergoing painless bronchoscopy.