Suzuki Takayoshi, Tsuda Shingo, Nakae Hirohiko, Imai Jin, Sawamoto Kana, Kijima Maiko, Tsukune Yoko, Uchida Tetsufumi, Igarashi Muneki, Koike Jun, Matsushima Masashi, Suzuki Toshiyasu, Mine Tetsuya
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai University Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.
Gastroenterol Res Pract. 2016;2016:2964581. doi: 10.1155/2016/2964581. Epub 2015 Dec 27.
Aim. The study assessed the usefulness of a recently developed method for respiratory rate (RR) monitoring in patients undergoing endoscopic submucosal dissection (ESD) under deep sedation. Methods. Study subjects comprised 182 consecutive patients with esophageal cancer or gastric cancer undergoing ESD. The usefulness of acoustic RR monitoring was assessed by retrospectively reviewing the patients' records for age, gender, height, weight, past history, serum creatinine, RR before ESD, and total dose of sedative. Results. Respiratory suppression was present in 37.9% of (69/182) patients. Continuous monitoring of RR led to detection of respiratory suppression in all these patients. RR alone was decreased in 24 patients, whereas both RR and blood oxygen saturation were decreased in 45 patients. Univariate analysis showed female gender, height, weight, and RR before treatment to be significantly associated with respiratory suppression. Multivariate analysis showed RR before treatment to be the only significant independent predictor [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.73-0.95, and P = 0.006] of respiratory suppression. Conclusion. In this study, the difference in RR before treatment between patients with and without respiratory suppression was subtle. Therefore, we suggest that acoustic RR monitoring should be considered in patients undergoing ESD under sedation to prevent serious respiratory complications.
目的。本研究评估了一种最近开发的方法在深度镇静下接受内镜黏膜下剥离术（ESD）患者的呼吸频率（RR）监测中的实用性。方法。研究对象包括182例连续接受ESD的食管癌或胃癌患者。通过回顾性查阅患者的年龄、性别、身高、体重、既往史、血清肌酐、ESD前的RR以及镇静剂总剂量等记录，评估声学RR监测的实用性。结果。37.9%（69/182）的患者出现呼吸抑制。对RR的持续监测导致在所有这些患者中均检测到呼吸抑制。仅RR降低的患者有24例，而RR和血氧饱和度均降低的患者有45例。单因素分析显示，女性性别、身高、体重以及治疗前的RR与呼吸抑制显著相关。多因素分析显示，治疗前的RR是呼吸抑制的唯一显著独立预测因素[比值比（OR）0.83，95%置信区间（CI）0.73 - 0.95，P = 0.006]。结论。在本研究中，有呼吸抑制和无呼吸抑制患者治疗前的RR差异细微。因此，我们建议在镇静下接受ESD的患者中应考虑采用声学RR监测，以预防严重的呼吸并发症。
