高流量鼻管氧化减少了在深度镇静下诊断灵活支气管镜检查期间脱的风险:一个随机对照试验
Ming Wang1,2, Longfei Wang3, Xuefei Zhou2
1Health Science Center, Ningbo University, Ningbo, China.
Frontiers in medicine
|January 26, 2026
概括
高流量鼻腔管 (HFNC) 在深度镇静灵活支气管镜 (FB) 期间显著降低脱风险. 这种方法还减轻了二氧化碳的保留,允许在没有输管的情况下进行更安全的程序.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
背景情况:
- 灵活支气管镜 (FB) 的深度镇静改善了手术条件,但增加了脱的风险.
- 高流量鼻腔管 (HFNC) 是一种潜在的干预措施,但其在FB深度镇静期间的疗效尚未得到充分证实.
研究的目的:
- 评估HFNC在深度镇静下灵活支气管镜检查期间减轻脱和CO2保留的疗效.
- 在这个患者群体中,比较HFNC与常规鼻 (NC) 的安全性和有效性.
主要方法:
- 一个随机试验,涉及340名患者,在深度镇静下接受FB (MOAA/S ≤1).
- 患者被分配给使用常规鼻腔管 (NC) 或HFNC,流量不同 (25,45,或65升/分钟).
- 主要结局包括手术期间脱的发生率 (SpO2>90%>10s) 和 SpO2的最低值;次要结局包括咳的严重程度和CO2水平.
主要成果:
- 与NC组 (57.14%,p < 0.000) 相比,HFNC组表现出明显较低的脱率 (5.00%16.87%).
- 所有HFNC队列都保持了较高的最低 SpO2 水平 (p < 0.000),并且与NC (p < 0.05) 相比,显示了较低的 CO2 保留率.
- 所有组的咳得分都很低,超过97%的人愿意重复FB手术.
结论:
- 在深度镇静下进行的灵活支气管镜检查时,HFNC显著降低了脱的风险.
- HFNC部分减轻二氧化碳的积累,有助于更安全的深沉镇静实践.
- 这些发现支持使用HFNC作为一种方法,以实现更安全的灵活支气管镜检查,而无需呼吸道输管.
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