CAJ | 학술논문

目的：比较在治疗性宫腔镜镇静镇痛过程中通过改良鼻咽通气道监测二氧化碳波形和通过监测脉搏氧饱和度和肉眼观察对低氧血症的预防。方法观察60例接受丙泊酚和芬太尼联合镇静镇痛行治疗性宫腔镜手术的女性患者，随机分为两组：接受二氧化碳波形监护的C组和不接受二氧化碳波形监测而使用脉搏氧饱和度监测和肉眼观察的P组。观察两组患者不同监测手段对窒息和呼吸紊乱等不良呼吸事件的发生的预警次数和低氧血症发生率。结果 C组检测到ADR33次，P组监测到16次；C组发生低氧血症为2例(6.7%)，明显低于P组9例(30%)，差异有统计学意义(<0.05)。结论与脉搏氧饱和度相比，二氧化碳波形监测能够更早更多的发现镇静镇痛过程中的不良呼吸事件，以便及时干预，预防低氧血症的发生，避免了由此引起的并发症。改良鼻咽通气道操作方便创伤小，并且提供了除气管内插管和喉罩以外的监测二氧化碳波形的条件，具有重要的临床价值。
목적：비교재치료성궁강경진정진통과정중통과개량비인통기도감측이양화탄파형화통과감측맥박양포화도화육안관찰대저양혈증적예방。방법관찰60례접수병박분화분태니연합진정진통행치료성궁강경수술적녀성환자，수궤분위량조：접수이양화탄파형감호적C조화불접수이양화탄파형감측이사용맥박양포화도감측화육안관찰적P조。관찰량조환자불동감측수단대질식화호흡문란등불량호흡사건적발생적예경차수화저양혈증발생솔。결과 C조검측도ADR33차，P조감측도16차；C조발생저양혈증위2례(6.7%)，명현저우P조9례(30%)，차이유통계학의의(<0.05)。결론여맥박양포화도상비，이양화탄파형감측능구경조경다적발현진정진통과정중적불량호흡사건，이편급시간예，예방저양혈증적발생，피면료유차인기적병발증。개량비인통기도조작방편창상소，병차제공료제기관내삽관화후조이외적감측이양화탄파형적조건，구유중요적림상개치。
Objective To investigate whether capnography is superior to pulse oximetry and visual assessment for the prevention of hypoxemia during therapeutic hysteroscopy. Methods 60 patients undergoing sedation and analgesia procedure receiving therapeutic hysteroscopy were randomly divided into two groups (C group and P group).P group received standard monitoring that included HR, ECG,NBP and pulse oximetry.C group received capnography monitoring through modified nasopharyngeal airway plus standard monitoring.Apnea and disordered respiration (ADR)and incidence of hypoxemia were investigated and rectified.Results Thirty-three episodes of ADR were discovered in C group while sixteen episodes of ADR were found in P group.There were two cases of hypoxemia and nine cases in P group.The incidence of hypoxemia in C group was significantly lower than in P group (6.7%vs.30%, <0.05). Conclusion Capnography is superior to pulse oximetry and visual assessment for the prevention of hypoxemia during therapeutic hysteroscopy.Modified nasopharyngeal airway provides a"closed loop"which is beneficial to capnography monitoring while it is minimal invasive and easy to practice.