【摘要】 目的探讨声门上通气在气道高风险患者无痛胃镜检查中应用的可行性和安全性。方法选取2020年10月-2021年3月我院60例气道高风险胃镜检查患者,随机分为观察组和对照组,每组30例。两组先静脉注射0.1μg/kg舒芬太尼,接着注射依托咪酯丙泊酚混合液0.15～0.2 ml/kg,待睫毛反射消失后,观察组置入声门上通气导管,并在胃镜监视下导管头端置于声门上1～2 cm处,然后开始行胃镜检查。对照组为鼻导管通气。观察两组麻醉前（T₀）、插入胃镜前（T₁）、插入胃镜后3 min（T₂）及检查结束时（T₃）的平均动脉压（MAP）、心率（HR）和血氧饱和度（SpO₂）,于T₂时采集桡动脉血测二氧化碳分压（PaCO₂）,记录术中托下颌、面罩给氧、置入喉罩等紧急处理情况。结果 T₁、T₂时对照组SpO₂低于T₀时,且低于观察组,差异有统计学意义（P<0.05）。T₁、T₂时两组MAP均下降,低于T₀时（P<0.05）,但组间差异无统计学意义（P>0.05）;观察组T₂时PaCO₂低于对照组（P<0.05）;观察组需要紧急处理的比例低于对照组（P<0.05）。结论声门上通气行无痛胃镜检查,可有效改善患者缺氧,并可避免二氧化碳潴留,使胃镜检查更安全。更多还原

【Abstract】 Objective To investigate the feasibility and safety of supraglottic ventilation in painless gastroscopy in patients with high risk of airway.Methods A total of 60 patients with airway high-risk gastroscopy in our hospital from October 2020 to March 2021 were randomly divided into observation group and control group, with 30 cases in each group. In the two groups, 0.1 μg/kg sufentanil was first injected intravenously, and then 0.15-0.2 ml/kg etomidate-propofol mixture was injected. After the eyelash reflex disappeared, the observation group was placed in the supraglottic ventilation catheter, and the catheter head was placed at 1-2 cm above the glottis under gastroscopy, and then gastroscopy was performed. The control group was nasal catheter ventilation. The mean arterial pressure（MAP）, heart rate（HR） and blood oxygen saturation（SpO₂） were observed before anesthesia（T₀）, before insertion of gastroscope（T₁）, 3 min after insertion of gastroscope（T₂） and at the end of examination（T₃） in the two groups. At T₂,the radial artery blood was collected to measure the partial pressure of carbon dioxide（PaCO₂）, and the emergency treatment situations such as jaw support, mask oxygen supply and laryngeal mask insertion were recorded.Results SpO₂ at T₁ and T₂ in the control group was lower than that at T₀, and lower than that in the observation group, the difference was statistically significant（P<0.05）. MAP decreased at T₁ and T₂ in both groups, which was lower than that at T₀（P<0.05）, but there was no significant difference between the two groups（P>0.05）. PaCO₂ at T₂ in the observation group was lower than that in the control group（P<0.05）. The proportion of emergency treatment in the observation group was lower than that in the control group（ P<0.05）.Conclusion Painless gastroscopy with supraglottic ventilation can effectively improve the patient’s hypoxia and avoid carbon dioxide storage,making gastroscopy safer.更多还原