摘要
目的分析医用外科口罩对老年患者中心静脉血氧分压(PcvO_(2))和中心静脉血氧饱和度(ScvO_(2))的影响,探讨围术期老年患者正确佩戴医用外科口罩的方法。方法回顾性对比分析2018-11/2019-10期间不佩戴医用外科口罩的对照1组(D1组,n=66)和2020年4~8月佩戴医用外科口罩的试验1组(S1组,n=51)的老年患者,麻醉诱导前(T_(0))、气管插管后15 min(T_(1))的PcvO_(2)和ScvO_(2);对比分析不佩戴医用外科口罩的对照2组(D2组,n=24)和佩戴医用外科口罩的试验2组(S2组,n=24)的老年患者入室时(T_(0))、给予低流量鼻导管吸氧后(T_(1))的PcvO_(2)和ScvO_(2)改变。结果D1与S1组、D2与S2组患者一般资料比较无统计学意义(P>0.05)。单纯佩戴医用外科口罩对麻醉诱导期氧摄取力的影响:与T_(0)比较,T_(1)时D1组和S1组患者PcvO_(2)、ScvO_(2)均快速升高,差异有统计学意义(P<0.01);T_(0)、T_(1)时,S1组患者PcvO_(2)、ScvO_(2)均低于D1,差异有统计学意义(P<0.05)。佩戴医用外科口罩配合鼻导管吸氧对提高氧摄取力的影响:与T_(0)比较,T_(1)时S2组患者PcvO_(2)、ScvO_(2)均明显升高(P<0.01);T_(1)时S2组PcvO_(2)和ScvO_(2)升高的幅度大于D2组,差异有统计学意义(P<0.05)。结论老年患者佩戴医用外科口罩增加呼吸阻力,导致静息状态下氧摄取效率下降,PcvO_(2)、ScvO_(2)下降,并影响气管插管后PcvO_(2)、ScvO_(2)的上升幅度;佩戴医用外科口罩同时给予小流量鼻导管吸氧能有效提高老年患者的氧摄取能力。
Objective To analyze the effects of surgical masks on central venous oxygen partial pressure(PcvO_(2))and central venous oxygen saturation(ScvO_(2))in elderly patients,and to explore methods of correctly wearing surgical masks for elderly patients in perioperative period.Methods PcvO_(2) and ScvO_(2) before anesthesia induction(T_(0))and 15 min after tracheal intubation(T_(1))in elderly patients of control group 1 without medical surgical mask(group D1,n=66),from November 2018 to October 2019 and those in experimental group 1 wearing medical surgical masks(group S1,n=51),from April to August 2020,were retrospectively analyzed;PcvO_(2) and ScvO_(2)of elderly patients who did not wear surgical masks in control group 2(group D2,n=24)and those who wore surgical masks in experimental group 2(group S2,n=24)were compared at T_(0) and T_(1).Results There was no significant difference in general data between group D1 and group S1,group D2 and group S2(P>0.05).The effect of medical surgical mask on oxygen uptake during anesthesia induction;compared with T_(0),PcvO_(2) and ScvO_(2) in group D1 and group S1 increased rapidly at T_(1) with statistically significant(P<0.01);at T_(0) and T_(1),PcvO_(2) and ScvO_(2) in group S1 were lower than those in group D1 with statistically significant(P<0.05).And,the effect of wearing medical surgical mask and nasal catheter oxygen inhalation on improving oxygen uptake:compared with T_(0),PcvO_(2) and ScvO_(2) in group S2 increased at T_(1) with statistically significant(P<0.01).The absolute value of PcvO_(2) and ScvO_(2) increased at T_(1) in group S2 was higher than those in group D2(P<0.05).Conclusion Wearing surgical masks increase respiratory resistance in the elderly patients,which leads to the decrease of oxygen uptake efficiency,the decrease of PcvO_(2) and ScvO_(2) in resting state,and the level of PcvO_(2) and ScvO_(2) after endotracheal intubation was decreased.Wearing surgical masks and giving small flow of nasal catheter oxygen inhalation can effectively improve the oxygen uptake ability for elderly patients.
作者
齐峰
费建平
包华芳
袁春英
赵赢
QI Feng;FEI Jianping;BAO Huafang;YUAN Chunying;ZHAO Ying(Operating Room,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China;Department of Anesthesiology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China;Post-anesthesia Care Unit,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China)
出处
《麻醉安全与质控》
2021年第5期249-252,共4页
Perioperative Safety and Quality Assurance
基金
2019年昆山市重点研发计划(社会发展专项指令性项目)(KS1954)。
作者简介
齐峰,主管护师,E-mail:kingsky5460@163.com;通信作者:费建平,E-mail:feijian961117@163.com。
