新型异形鼻咽通气管在阻塞性睡眠呼吸暂停低通气综合征患者行无痛胃肠镜检查中的应用

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Abstract Objective To investigate the safety and efficacy of a new type of special-shaped nasopharyngeal catheter in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) undergoing painless gastroscopy. Methods A total of 90 OSAHS patients who underwent painless gastroscopy examination in the outpatient department of Characteristics Medical Center of PLA Air Force from October 2022 to March 2023 were randomly divided into a control group (Group C), nasopharyngeal airway group 1 (Group NPA1), and nasopharyngeal airway group 2 (Group NPA2). Oxygen masks were used in Group C for oxygen inhalation, while NPA1 and NPA2 were given by nasopharyngeal catheter, and PetCO₂ was monitored in group NPA2. The general condition, airway assessment indicators (Malampati classification), incidence of hypoxemia in painless gastroenteroscopy, incidence of respiratory depression, auxiliary ventilation rate, minimum oxygen saturation, and the interval time from hypoxemia alarm value to hypoxemia occurrence were observed and compared among the groups. Results The incidence of respiratory depression in Group NPA1(40.0%) was lower than that in Group C (70.0%) .The incidence of hypoxemia in Group NPA1 (23.3%) was lower than that in Group C (50.0%), and auxiliary ventilation rate in Group NPA1(33.3%) was lower than that in Group NPA2 (46.7%) and lower than that in Group C (66.7%). The lowest blood oxygen saturation in Group NPA1 [(92 93±3.60)%] was higher than that of Group C[(90.20±4.34)%], and lower than that of Group NPA2 [(94.67±2.63)%]. The time interval between alarm value of hypoxemia and occurrence of hypoxemia in Group NPA2 [(63.25±10.28)s] was longer than that in Group NPA1 [(22.14±4.10)s], and the difference was statistically significant (P<0 05). In Group C, 2 subjects were transferred to Group NPA1 due to persistent hypoxemia, and SpO₂ gradually recovered to normal level after the placement of nasopharyngeal catheter. Conclusions The new special-shaped nasopharynx catheter can effectively reduce the incidence of respiratory depression and hypoxemia, and improve the safety of painless gastroscopy for OSAHS patients. Combined PetCO₂ monitoring can guide anesthesiologists to conduct auxiliary ventilation treatment, further reduce the incidence of respiratory depression, and improve the safety of surgery.

Key words： obstructive sleep apnea-hypopnea syndrome nasopharyngeal catheter hypoxemia end-tidal carbon dioxide partial pressure painless gastroscopy

Received: 07 July 2023

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	Articles by authors
	WU Tong
	TAO Tianzhu
	YANG Xiaoming
	DONG Jiaxin
	CHEN Yuqi
	LI Bairong
	YE Bo

Cite this article:

WU Tong,TAO Tianzhu,YANG Xiaoming等. Application of a new special-shaped nasopharyngeal catheter in painless gastroscopy in patients with OSAHS[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(12): 1021-1024.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I12/1021

[1]	黄美清. 依托咪酯与异丙酚在老年人无痛胃肠镜检查中的应用 [J]. 中国医药指南, 2012, 10(10): 595-596.
[2]	Kaparianos A, Sampsonas F, Karkoulias K, et al. Obstructive sleep apnoea syndrome and genes [J].Neth J Med, 2006, 64(8): 280-289.
[3]	杨晓春,谢咏秋,赵婉莹,等.不同配比依托咪酯-丙泊酚混合液在无痛胃镜中的应用比较 [J].临床麻醉学杂志, 2018, 34(3): 246-249.
[4]	Jordan A S, McSharry D G, Malhotra A. Adult obstructive sleep apnoea [J]. Lancet, 2014, 383(9918):736-747.
[5]	吴慕坤,孙建军. 阻塞性睡眠呼吸暂停低通气综合征气道解剖功能异常的研究进展 [J]. 中国眼耳鼻喉科杂志, 2020, 20(3): 266-268.
[6]	Apfelbaum J L, Hagberg C A, Caplan R A, et al. Practice guidelines for management of the difficult airway: an updated report by the americansociety of anesthesiologists task force on management of the difficult airway [J]. Anesthesiology, 2013,118(2): 251-270.
[7]	贵艳玲,张林霞.经鼻咽通气道吸痰与常规方式吸痰的对比观察 [J].国际护理学杂志,2009,28(4):515-516.
[8]	代恒茂,明伟,周志强,等.呼气末二氧化碳分压监测在全麻拔管后苏醒期患者中的应用[J].护理学杂志, 2022, 37(12): 36-38.
[9]	林艳.呼气末二氧化碳分压监测在心肺复苏中的应用现状[J].中国医学创新,2017, 14(25): 133-136.
[10]	Siobal M S. Monitoring exhaled carbon dioxide [J].Respir Care,2016, 61(10): 1397-1416.
[11]	Zhang C,Wang M, Wang R,et al.Accuracy of end-tidal CO2 measurement through the nose and pharynx in nonintubated patients during digital subtraction cerebral angiography[J].J Neurosurg Anesth,2013,25(2):191-196.
[12]	Cereceda-Sánchez F J, Molina-Mula J.Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting [J]. Rev Lat Am Enfermagem,2017,25:e2885.
[13]	中华医学会消化内镜学分会麻醉协作组.常见消化内镜手术麻醉管理专家共识[J].临床麻醉学杂志, 2019,35(2):177-185.
[14]	Gallagher J J.Capnographymonitoring during procedural sedation and analgesia[J].AACN Adv Crit Care, 2018,29(4):405-414.