提高老年肥胖患者行无痛胃镜检查安全性探讨

摘要

Objective:To discuss the preoxygenation-operative placement nasopharyngeal airway and endoscopic mask preventive obese elderly patients with painless gastroscopy hypoxemia.Method:From June to December 2015,100 cases of elderly obese patients who need painless gastroscopy in our hospital were selected as the research objects,they were randomly divided into control group and observation group,each group had 50 cases.The control group was used conventional nursing method of nasal catheter oxygen inhalation,the observation group was used mask pre-oxygen anesthesia start 3 to 5 min,intraoperative placement of nasopharyngeal airway combined with endoscopic mask oxygen inhalation during the examination,the changes of blood oxygen saturation (SpO2) at different time points,hyoxemia and the occurrence of apnea in two groups were compared.Result:The two groups of SpO2 were lower than the 1 min in gastroscopy and then increased,observation group were better than control group,the differences were statistically significant(P<0.05).The occurrence situation of hypoxia and apnea in the observation group were lower than the control group,the differences were statistically significant (P<0.05).Conclusion:Using the mask preoxygenation 3 to 5 min before painless gastroscopy can effectively improve the body's oxygen storage capacity in obese elderly patients.Intraoperative placement nasopharyngeal airway endoscopy in conjunction with oxygen mask can significantly reduce and prevent respiratory depression caused by intravenous anesthesia,not only reduce the risk of hypoxaemia,but also improve the security checks.%目的：探讨采用术前预吸氧结合术中放置鼻咽通气管和使用内镜面罩给氧的方法，对老年肥胖患者行无痛胃镜检查中低氧血症的预防作用。方法：选取2015年6-12月本院收治的行无痛胃镜检查的100例老年肥胖患者作为研究对象，随机分为对照组和观察组，每组50例。对照组采用常规术中鼻导管吸氧的护理方法，观察组采用麻醉开始3~5 min面罩预吸氧，术中放置鼻咽通气管结合检查过程中使用内镜面罩吸氧的护理方法，比较两组患者检查过程中不同时间点血氧饱和度（SpO2）变化情况、低氧血症及呼吸暂停发生情况。结果：两组SpO2均于胃镜检查1 min时降低，随后升高，且观察组优于对照组，比较差异有统计学意义（P<0.05）；观察组发生低氧血症和呼吸暂停情况均低于对照组，比较差异均有统计学意义（P<0.05）。结论：老年肥胖患者行无痛胃镜检查前采用面罩预吸氧3~5 min，可有效提高机体氧储备能力，术中放置鼻咽通气管结合使用内镜面罩给氧可明显减轻和预防静脉麻醉引起的呼吸抑制，降低发生低氧血症的风险，提高检查的安全性。