Kinoshita Y, Nishiyama K, Kitajima N, Ito T, Inatome T, Fukuzaki H, Chiba T
Department of Internal Medicine, Miki City Hospital.
Nihon Ronen Igakkai Zasshi. 1992 Mar;29(3):185-9. doi: 10.3143/geriatrics.29.185.
Although endoscopy is widely used for safe and accurate examinations of gastroduodenal disease cases, several investigators reported arterial oxygen desaturation occurring during endoscopy. Endoscopy-induced oxygen desaturation is hazardous because it increases the risk of cardiac arrhythmia. This study is designed to investigate whether gastroduodenal endoscopy causes remarkable oxygen desaturation in elderly patients in comparison with younger ones and to study whether nasal oxygen administration can prevent it. Forty-four patients over 61 years old and 37 patients younger than 60 were divided into two groups, to one of which 100% oxygen (2 l/min) was administered through nasal prongs. During endoscopy, blood pressure, pulse rate, and arterial oxygen saturation (SaO2) were recorded at one-minute intervals by a pulse oximeter. Intubation of the endoscope caused a transient drop in oxygen saturation both younger and older patients with greater drops in older subjects (1.7 +/- 0.4% in the young and 3.3 +/- 0.8% in the old groups). In the older groups, two out of 20 patients who had no oxygen administration showed a saturation decrease of over 7%. On the other hand, no younger subject showed such a large degree of oxygen desaturation. Oxygen administration effectively prevented the endoscopy-induced desaturation both in younger and in older patients. In summary, the results of this study suggested that older subjects had a greater decrease of oxygen saturation during gastroduodenofiberscopy and that oxygen administration is useful to prevent the endoscopy-induced desaturation.
尽管内镜检查广泛应用于胃十二指肠疾病的安全、准确检查，但有几位研究者报告在内镜检查过程中会出现动脉血氧饱和度降低的情况。内镜检查引起的血氧饱和度降低是危险的，因为它会增加心律失常的风险。本研究旨在调查与年轻患者相比，胃十二指肠内镜检查是否会导致老年患者出现明显的血氧饱和度降低，并研究经鼻给氧是否可以预防这种情况。将44名61岁以上的患者和37名60岁以下的患者分为两组，其中一组通过鼻导管给予100%氧气（2升/分钟）。在内镜检查期间，通过脉搏血氧仪每隔一分钟记录血压、脉搏率和动脉血氧饱和度（SaO2）。内镜插入导致年轻和老年患者的血氧饱和度短暂下降，老年受试者下降幅度更大（年轻组为1.7±0.4%，老年组为3.3±0.8%）。在老年组中，20名未吸氧的患者中有2名血氧饱和度下降超过7%。另一方面，没有年轻受试者出现如此大幅度的血氧饱和度降低。给氧有效地预防了年轻和老年患者内镜检查引起的血氧饱和度降低。总之，本研究结果表明，老年受试者在纤维胃十二指肠镜检查期间血氧饱和度下降幅度更大，给氧有助于预防内镜检查引起的血氧饱和度降低。
