Cai Guangyu, Huang Zhenling, Zou Tianxiao, He Miao, Wang Shanjuan, Huang Ping, Yu Bin
Department of Anesthesiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Anesthesiology, Renji Hospital affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Int J Med Sci. 2017 Feb 8;14(2):167-172. doi: 10.7150/ijms.16919. eCollection 2017.
Desaturation during painless gastroscopy in aged patients leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. An endoscopic nasal mask was designed to control hypoxia during the above procedures. A randomized trial was performed to test whether the novel endoscopic mask is helpful for hypoxia during painless gastroscopy in aged patients. In this randomized, controlled trial, 141 aged patients undergoing painless gastroscopy were randomized into nasal catheter group (69 patients) and endoscopic mask group (65 patients). Primary outcomes were minimum pulse oxygen saturation and incidence of pulse oxygen saturation ≤ 90%. Finally 134 aged patients were analyzed, including 69 patients in nasal catheter group and 65 patients endoscopic mask group. The minimum pulse oxygen saturation (96.4% ± 4.8%) was higher in the aged endoscopic mask group than in the aged nasal catheter group (94.3% ± 5.6%, P = 0.0075). The incidence of pulse oxygen saturation ≤ 90% did not significantly differ between the endoscopic mask group and nasal catheter group (6.2% VS 15.9%, P = 0.07). There were no severe adverse events in either groups. The endoscopic mask was safely used in aged patients during painless gastroscopy under propofol sedation and significantly improved the minimum pulse oxygen saturation without increasing time to examination or recovery time.
老年患者在无痛胃镜检查过程中出现的血氧饱和度下降会导致检查中断、操作时间延长以及严重并发症风险增加。为此设计了一种内镜鼻罩，用于在上述检查过程中控制低氧情况。开展了一项随机试验，以测试这种新型内镜鼻罩对老年患者无痛胃镜检查期间低氧情况是否有帮助。在这项随机对照试验中，141例接受无痛胃镜检查的老年患者被随机分为鼻导管组（69例患者）和内镜鼻罩组（65例患者）。主要观察指标为最低脉搏血氧饱和度以及脉搏血氧饱和度≤90%的发生率。最终对134例老年患者进行了分析，其中鼻导管组69例，内镜鼻罩组65例。老年内镜鼻罩组的最低脉搏血氧饱和度（96.4%±4.8%）高于老年鼻导管组（94.3%±5.6%，P=0.0075）。内镜鼻罩组和鼻导管组之间脉搏血氧饱和度≤90%的发生率无显著差异（6.2%对15.9%，P=0.07）。两组均未出现严重不良事件。在丙泊酚镇静下的无痛胃镜检查过程中，内镜鼻罩在老年患者中使用安全，显著提高了最低脉搏血氧饱和度，且未增加检查时间或恢复时间。
