高流量鼻与面罩在肝脏射频切除过程中对动脉氧化的作用:随机对照试验
Jung-Pil Yoon1, Go Wun Kim2, Ji-Uk Yoon1
1Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Republic of Korea.
Medicina (Kaunas, Lithuania)
|July 30, 2025
概括
高流量鼻腔管 (HFNC) 在监控麻醉护理 (MAC) 下在射频剥离 (RFA) 期间显著改善了氧气水平. 然而,与简单的面罩相比,它没有减少缺氧或改善其他临床结果.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 干预性放射学 干预性放射学
背景情况:
- 在监控麻醉护理 (MAC) 下,通过皮肤进行肝脏射频除 (RFA) 存在由于呼吸抑制而导致缺氧的风险.
- 保持足够的氧化对于在RFA过程中患者的安全至关重要.
研究的目的:
- 为了比较高流量鼻腔管 (HFNC) 与简单面罩在改善MAC下RFA期间氧化的有效性.
- 评估HFNC对动脉部分氧气压 (PaO2),缺氧发生率和呼吸系统参数的影响.
主要方法:
- 一项前性随机对照试验,涉及51名在MAC下接受超声导向RFA的患者.
- 患者被随机分配,通过HFNC (30L/分钟) 或面罩 (6L/分钟) 接受氧气.
- 在基线和氧化后5分钟分析了动脉血液气体.
主要成果:
- 与面罩组相比,HFNC组在手术过程中的PaO2显著更高 (299对194mmHg,p<0.001).
- 两组之间没有观察到缺氧发生率,PaCO2或患者满意度的显著差异.
- 在整个过程中,HFNC组的呼吸速率 (RR) 保持更稳定 (p = 0.003).
结论:
- 在MAC下,HFNC在RFA期间显著增强了程序内氧化.
- 与面罩氧化相比,HFNC并没有减少缺氧发生率或改善其他临床结果.
- 与HFNC观察到的RR稳定性表明需要进一步研究的潜在生理益处.
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