| .经鼻高流量湿化氧疗在全麻下Pierre-Robin序列征婴幼儿
窒息插管期的应用研究[J].现代生物医学进展英文版,2024,(24):4774-4777. |
| 经鼻高流量湿化氧疗在全麻下Pierre-Robin序列征婴幼儿
窒息插管期的应用研究 |
| Application Study of High-Flow Humidified Nasal Cannulain the Intubation Period of Asphyxia in Infants with Pierre-RobinSequence Syndrome Under General Anesthesia |
| Received:September 09, 2024 Revised:October 12, 2024 |
| DOI：10.13241/j.cnki.pmb.2024.24.043 |
| 中文关键词: 经鼻高流量湿化氧疗 Pierre-Robin序列征 婴幼儿 全麻 窒息插管期 |
| 英文关键词: |
| 基金项目:江苏省卫生健康委医学科研重点项目（K2023066） |
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| 中文摘要: |
| 摘要 目的：探讨经鼻高流量湿化氧疗（HFNC）在全麻下对Pierre-Robin序列征（PRS）婴幼儿窒息插管期的应用效果。方法：采用随机数字表法将68例全麻下行双侧下颌骨牵引成骨术（MDO）的PRS患儿分为对照组和研究组，各为34例。对照组予以常规插管，研究组在对照组基础上予以HFNC，对比两组插管次数、插管时间、气管拔管时间、首次气管插管成功率、血流动力学指标[心率（HR）、平均动脉压（MAP）]、血气指标[动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）、动脉二氧化碳分压（PaCO2）]及并发症发生率。结果：研究组与对照组插管次数、插管时间、气管拔管时间、首次气管插管成功率比较，差异具有统计学意义（P＜0.05）。插管成功后（T2）时间点两组HR、MAP升高（P＜0.05）。T2时间点两组HR、MAP比较，差异无统计学意义（P＞0.05）。T2时间点两组PaO2、SaO2下降，PaCO2升高（P＜0.05）。T2时间点研究组PaO2、SaO2高于对照组，PaCO2低于对照组（P＜0.05）。研究组的并发症发生率低于对照组（P＜0.05）。结论：在全麻下PRS患儿窒息插管期应用HFNC，可有效减少插管次数，缩短插管时间和气管拔管时间，提高首次气管插管成功率，改善患儿的血流动力学和血气指标，同时还可降低并发症发生率，应用效果显著。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of high-flow humidified nasal cannula (HFNC) on Pierre-Robin sequence syndrome (PRS) in infants with asphyxia during intubation under general anesthesia. Methods: 68 children with PRS who underwent bilateral mandibular distraction osteogenesis (MDO) under general anesthesia were divided into control group and research group by random number table method, with 34 cases in each group. Control group was given routine intubation, and research group was given HFNC on the basis of control group. The number of intubation attempts, intubation time, tracheal extubation time, success rate of first tracheal intubation, hemodynamic indexes [heart rate (HR), mean arterial pressure (MAP)], blood gas indexes [arterial oxygen partial pressure (PaO2), arterial oxygen saturation (SaO2), arterial carbon dioxide partial pressure (PaCO2)] and incidence of complications were compared between two groups. Results: There were statistically significant differences in the number of intubations, intubation time, tracheal extubation time, and the success rate of first tracheal intubation between the study group and the control group(P<0.05). HR and MAP increased in both groups after successful intubation (T2) (P<0.05). There was no significant difference in HR and MAP between the two groups at T2 (P>0.05). PaO2 and SaO2 decreased and PaCO2 increased in both groups at T2 time point (P<0.05). PaO2 and SaO2 were higher and PaCO2 lower in research group than in control group at T2 time point (P<0.05). The incidence of complications in research group was lower than that in control group(P<0.05). Conclusion: The application of HFNC in the asphyxial intubation period of PRS children under general anesthesia can effectively reduce the number of intubation attempts, shorten the intubation time and tracheal extubation time, improve the success rate of the first tracheal intubation, improve the hemodynamics and blood gas indexes of the children, and reduce the incidence of complications, the application effect is significant. |
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