Efficiency of bedside flexible bronchoscope supported by high flow oxygen therapy
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摘要:目的 探讨高流量氧疗支持下床旁可弯曲支气管镜的应用效果。方法 选取27例鼻导管/面罩吸氧组患者(A组)及51例高流量吸氧组患者(B组)，分析2组患者术前及术中平均动脉压(MAP)、心率(HR)的变化，以及2组患者术前、术后的氧合指数[p(O2)/FiO2]和二氧化碳分压[p(CO2)]的变化。结果 2组术中MAP均较术前升高，其中B组ΔMAP为(12.1±4.7) mmHg, A组ΔMAP为(16.3±5.2) mmHg，差异有统计学意义(P=0.001)。2组术中HR均较术前升高, B组ΔHR为(21.2±11.2)次/min, A组ΔHR为(26.7±11.3)次/min, 差异有统计学意义(P=0.045)。2组术后p(O2)/FiO2均较术前降低，其中B组Δp(O2)/FiO2绝对值为(-9.5±19.5) mmHg, 低于A组Δp(O2)/FiO2绝对值(-23.6±12.2) mmHg, 差异有统计学意义(P=0.002)。2组术后p(CO2)均较术前升高, B组Δp(CO2)为(2.7±4.7) mmHg, 低于A组Δp(CO2) (5.0±3.0) mmHg, 差异有统计学意义(P=0.02)。结论 经鼻高流量氧疗可能减少床旁可弯曲支气管镜检查中MAP、HR变异率，降低检查风险，提高患者对检查的耐受性。Abstract:Objective To explore the clinical effect of bedside flexible bronchoscope supported by high flow oxygen therapy.Methods Totally 27 cases with nasal catheter/mask oxygen inhalation were selected as group A and 51 cases with high flow oxygen inhalation were selected as group B. Changes of mean arterial pressure (MAP) and heart rate (HR) before and during operation were analyzed, and the changes of oxygen index [p(O2)/FiO2] and partial pressure of carbon dioxide [p(CO2)] before and after operation were analyzed as well.Results The intra-operative MAP in both groups was higher than that before operation. The ΔMAP in group B was (12.1±4.7) mmHg, while that in group A was (16.3±5.2) mmHg, and there was a significant difference between two groups (P=0.001). The intra-operative HR in both groups was higher than that before operation. The ΔHR in group B was (21.2±11.2) times per minute, and that in group A was (26.7±11.3) per minute, and there was a significant difference between two groups (P=0.045). Postoperative p(O2)/FiO2 in both groups was lower than that before operation. The absolute value of Δp(O2)/FiO2 in group B was (-9.5±19.5) mmHg, which was lower than (-23.6±12.2) mmHg in group A, and there was a significant difference between two groups (P=0.002). Postoperative p(CO2) in both groups was higher than that before operation. The Δp(CO2) in group B was (2.7±4.7) mmHg, which was lower than (5.0±3.0) mmHg in group A, and there was a significant difference between two groups (P=0.02).Conclusion Transnasal high flow oxygen therapy may reduce the variation rates of MAP and HR in patients with bedside flexible bronchoscope, reduce the risk of examination and improve the patient′s tolerance to examination.
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Keywords:
- hypoxemia /
- high flow oxygen therapy /
- flexible bronchoscope /
- oxygenation index /
- variation rate
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表 1 2组患者临床资料比较(X±s)
临床资料 A组(n=27) B组(n=51) 年龄/岁 69.4±6.4 72.6±5.9 男 20/7 35/16 女 7 16 术前平均动脉压/mmHg 97.0±15.8 96.9±18.1 术前心率/(次/min) 82.4±6.4 83.7±6.3 术前p(O2)/FiO2/mmHg 329.6±55.2 315.7±55.5 术前p(CO2)/mmHg 54.9±9.9 56.6±9.7 术中平均动脉压/mmHg 113.2±14.4 109.0±18.7 术中心率/(次/min) 109.1±14.5 104.9±10.6 术后p(O2)/FiO2/mmHg 306.0±58.8 305.8±58.7 术后p(CO2)/mmHg 60.0±9.1 59.2±10.7 
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