吸氧对纤维支气管镜检查患者相关血气指标的干预和影响

Intervention and Effects of Oxygen Inhalation on Blood Gas Analysis in Patients Undergoing Flexible Bronchoscopy

目的 了解中等浓度吸氧在纤维支气管镜 (FB)检查中的安全性和价值。方法 在行FB检查人群中随机选择 2 5例 ,分别观察FB置入气道 (置镜 )前后及中等浓度吸氧前后患者动脉血氧分压 (PaO2 )、动脉血二氧化碳分压(PaCO2 )和血氧饱和度 (SpO2 )的变化。结果 置镜使患者SpO2 和PaO2 有显著下降 (P <0 .0 0 1) ,而PaCO2 差异无显著性 (P >0 .0 5 )。接着吸氧 5L/min后 ,SpO2 和PaO2 与置镜后比较 ,有明显提高 (P <0 .0 0 1) ,而PaCO2 变化无统计学意义 (P >0 .0 5 )。 13例患者置镜前和吸氧后PaO2 及SpO2 比较 ,差异均具明显显著性 (P <0 .0 1) ,而PaCO2 无明显变化 (P >0 .0 5 )。结论 吸中等浓度氧对普通行FB检查的患者是安全的 ,可完全补偿因FB置入所引起的PaO2 下降 ,而对PaCO2 影响很小 ,对于有原发PaCO2 升高的患者 。

Objective To investigate clinic safety and value of moderate oxygen inhalation during flexible bronchoscopy (FB).Methods The effects of FB procedures and moderate oxygen inhalation on arterial oxygen tension (PaO 2), arterial carbon dioxide tension (PaCO 2), and arterial oxygen saturation measured by pulse oximetry (SpO 2 ) were observed in twenty five patients who needed FB examination and were selected at random.Results FB resulted in a significant decrease of SpO 2 and PaO 2 (P<0.001), and there was no difference in PaCO 2 (P>0.05). Oxygen inhalation (5 L/min by nasal canula) during the FB procedure resulted in a significant increase of SpO 2 and PaO 2 (P<0.001), and there was no significant effect on PaCO 2 (P>0.05). There was statistically significant increase in PaO 2 and SpO 2 in thirteen patients during oxygen inhalation compared with those before the FB procedure (P<0.01),and there was no difference in PaCO 2 (P>0.05).Conclusion Moderate oxygen inhalation is safe to patients who undergo routine FB examination. Oxygen inhalation can compensate for decreased SpO 2 and PaO 2 arising from the FB procedure, though it has little effect on PaCO 2.Safety of oxygen inhalation in patients with primary high level of PaCO 2 needs to be studied further.