International Journal of Surgery Open最新文献_第8页

Indolent presentation of a right-sided spontaneous diaphragmatic hernia: A case report and review of the literature 右侧自发性膈疝的惰性表现:1例报告及文献复习

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-09-01 DOI: 10.1016/j.ijso.2023.100662

Michael J. Warn , Austin R. Swisher , Alexandra Pitco , Zahan Ghyaz , Ross Vitek , Neharika Khurana

Introduction and Importance

Diaphragmatic hernias are the herniation of abdominal contents through the diaphragm into the thorax and are categorized as congenital or acquired. Most commonly, acquired diaphragmatic hernia is preceded by blunt or penetrating trauma to the abdomen with the former occurring more frequently. In less than 1% of cases, acquired diaphragmatic hernias can occur spontaneously, which can be recognized incidentally on imaging or by patients presenting with non-specific symptoms. Without prompt diagnosis, patients are at risk for incarceration and strangulation of the herniated contents, resulting in bowel necrosis.

Case presentation

Here, we present the case of a 36-year-old male who presented with worsening 3-month history of dyspnea and palpitations. Initial clinical exam was notable for tachypnea and accessory muscle recruitment. Auscultation revealed bowel sounds in the right lung fields. Semi-upright chest radiograph uncovered a large right-sided pneumothorax containing portions of the stomach, liver, and numerous loops of bowel, with significant cardiomediastinal left shift. Surgical intervention for diaphragmatic hernia repair was promptly planned.

Clinical discussion

Spontaneous diaphragmatic hernia occurring secondary to a defect on the right side of the diaphragm without any history of trauma or surgery is an extraordinarily infrequent pathology. This subacute clinical presentation despite extensive anatomic involvement highlights the importance of thorough physical examination, with auscultation of bowel sounds in the thorax serving as a near pathognomonic finding for a spontaneous diaphragmatic hernia, including patients without a known history of acute trauma or previous surgery.

Conclusion

Surgical management of such rare hernias via abdominal, thoracic, or a combined approach coupled with pulmonary monitoring proves to be an effective treatment, and awareness of this case will aid in its identification and the ability to provide prompt intervention.

膈疝是指腹部内容物通过膈疝进入胸腔，分为先天性和后天两种。最常见的是，获得性膈疝发生在腹部钝性或穿透性创伤之前，前者发生的频率更高。在不到1%的病例中，获得性膈疝可以自发发生，这可以在影像学上偶然发现或由出现非特异性症状的患者识别。如果不能及时诊断，患者将面临疝内容物嵌顿和绞窄的危险，从而导致肠坏死。病例报告在此，我们报告一位36岁的男性，他表现出恶化的3个月的呼吸困难和心悸病史。初步临床检查有明显的呼吸急促和副肌恢复。听诊显示右肺野有肠音。半直立胸片显示一大片右侧气胸，包括胃、肝和肠袢的一部分，并伴有明显的心膈向左移位。手术干预膈疝修补及时计划。临床讨论自发性膈疝继发于膈右侧缺损，无任何外伤或手术史，是一种极为罕见的病理。尽管有广泛的解剖累及，但这种亚急性的临床表现强调了彻底的体格检查的重要性，对自发性膈疝，包括没有已知急性创伤史或既往手术的患者，胸部听诊肠音是一种接近病理特征的发现。结论经腹、胸或联合入路手术治疗此类罕见疝并辅以肺监测是一种有效的治疗方法，对此类病例的认识有助于对其进行识别并及时进行干预。

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引用次数: 0

A case report of laparoscopic omental patch repair in a patient with super-super obesity and a duodenal perforation 腹腔镜网膜修补术治疗1例超级肥胖合并十二指肠穿孔患者

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100657

Takaaki Murata , Nobuo Yamaguchi , Yutaro Shimomoto , Yuto Igarashi , Yuma Suno , Tomoki Nishida , Katsunori Miyake , Naoko Isogai , Ryuta Fukai , Hiroyuki Kanomata , Rai Shimoyama , Jun Kawachi

Introduction

We report a case of emergency laparoscopic omental patch repair in a patient with super-super obesity (body mass index of 64.7) who presented with upper gastrointestinal perforation.

Case presentation

A 52-year-old male patient with difficulty moving his body due to abdominal pain was transported to the emergency department. Contrast-enhanced computed tomography revealed duodenal bulb wall thickening and increased fat stranding in the surrounding tissue. Free air was also observed under the liver and on its surface. Therefore, diagnostic laparoscopy was performed because of a suspected upper gastrointestinal perforation.

Clinical discussion

Because the weight limit of the surgical bed was 150 kg and the width was insufficient, even when two beds were placed side-by-side, the patient's fixation on the bed was unstable, and the surgery was performed on a regular hospital bed. A 5-mm full-thickness perforation of the duodenal bulb wall was confirmed, and omental patch repair was performed. Because the bed was regular, securing the visual field without changing the patient's position was difficult. There were also limitations on the movement of the ports; therefore, seven ports were used. Postoperatively, bile-like drainage was observed from the surgical drain. However, upper gastrointestinal contrast imaging on the 14th day after the surgery revealed no contrast leakage.

Conclusion

The patient recovered well and was discharged on the 31st day after the surgery.

我们报告一例以上消化道穿孔为表现的超超肥胖(体重指数为64.7)患者进行急诊腹腔镜网膜补片修复。病例介绍一名52岁男性患者，因腹部疼痛导致身体移动困难，被送往急诊科。增强计算机断层扫描显示十二指肠球壁增厚，周围组织脂肪增多。在肝脏的下面和表面也观察到自由空气。因此，诊断性腹腔镜检查，因为怀疑上消化道穿孔。临床讨论由于手术床的重量限制为150kg，宽度不足，即使两张床并排放置，患者在床上的固定也不稳定，手术是在医院的常规病床上进行的。证实十二指肠球壁有5mm全层穿孔，并行网膜补片修复。由于床是规则的，在不改变病人体位的情况下确保视野是困难的。港口的移动也受到限制;因此使用了7个端口。术后从手术引流管中观察到胆样引流。然而，术后第14天的上胃肠造影显示没有造影剂渗漏。结论患者术后31天恢复良好，出院。

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引用次数: 0

Laparoscopic removal of a giant adrenal myelolipoma: A case report with review of the literature 腹腔镜下巨大肾上腺髓性脂肪瘤切除术一例报告并文献复习

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100658

Dlshad Hamasaeed Ahmed , Rawa Bapir , Belan Mikaeil M. Radha , Ismaael Aghaways , Rezheen J. Rashid , Deari A. Ismaeil , Omar H. Ghalib Hawramy , Dana T. Gharib , Hemn H. Kaka Ali , Fahmi H. Kakamad , Berun A. Abdalla , Ari M. Abdullah

Introduction

Adrenal myelolipomas (AMLs) are non-functioning, benign adrenal tumors with an unknown etiology. This study aims to report a case of giant AML managed successfully by laparoscopic surgery.

Case presentation

A 43-year-old man presented with mild, dull, and non-radiating left loin pain. Physical examination and hormonal assays were normal. Imaging revealed a retroperitoneal mass (13 × 12 × 8.5cm) containing gross fat. Left laparoscopic adrenalectomy was done under general anesthesia. The postoperative period was uneventful. The patient was followed up for a duration of six months, and no recurrence was detected.

Discussion

AMLs are lipomatous tumor-like growths equally seen in both genders and are commonly incidental findings. Symptomatic AMLs are characterized by their large size, leading to the manifestation of pressure-related symptoms or abnormalities in hormonal levels. Most AMLs are associated with chronic diseases like diabetes mellitus and hypertension. The tumor is commonly diagnosed through a biochemical and imaging workup. Asymptomatic AMLs are managed conservatively, while in the presence of symptoms, surgery is usually considered. However, the open approach is regarded as the standard option, but minimally invasive approaches can be carried out due to their feasibility.

Conclusion

AMLs are rare, benign, non-functional tumors of the adrenal gland. Laparoscopy may be a safe and feasible management modality for these tumors.

肾上腺骨髓瘤(AMLs)是一种无功能的良性肾上腺肿瘤，病因不明。本研究旨在报告一例腹腔镜手术成功治疗的巨大急性髓性白血病。病例表现:一名43岁男性，表现为轻度、钝性、非辐射性左腰疼痛。体格检查和激素检查均正常。影像学显示腹膜后肿块(13 × 12 × 8.5cm)，含粗脂肪。全麻下行左腹腔镜肾上腺切除术。术后顺利。随访6个月，未见复发。aml是一种脂肪瘤样肿瘤，男女均可见，通常是偶然发现的。症状性aml的特点是体积较大，可导致压力相关症状或激素水平异常的表现。大多数aml与慢性疾病如糖尿病和高血压有关。肿瘤通常通过生化检查和影像学检查来诊断。无症状的aml通常采用保守治疗，而出现症状时通常考虑手术治疗。然而，开放入路被认为是标准选择，但由于微创入路的可行性，可以进行。结论aml是一种少见的肾上腺良性非功能性肿瘤。腹腔镜可能是一种安全可行的治疗方法。

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引用次数: 0

Idiopathic encapsulating peritonitis: A case report 特发性囊性腹膜炎1例

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100655

Tamassi Bertrand Essobiyou , Samuel Salem Laurent Ouedraogo , Pegwende Rachid Cedric Diendere , Albert Kossi Labou , Mohamed Issa , Kodjo Abossisso Sakiye

Introduction

and importance: Encapsulating peritonitis is a chronic and rare condition of the peritoneum. Most often secondary, it can occur idiopathically without any predictive factor. The diagnosis is often delayed and the management is not codified. The authors report a case of encapsulating peritonitis in a patient in a hospital in Togo. Their case highlights the diagnostic difficulties that can arise with encapsulated peritonitis.

Case presentation

a 46-year-old female patient with a history of transient abdominal pain was admitted to an emergency with acute intestinal obstruction. A laparotomy was indicated. Intraoperatively, it was discovered that there was an agglutination of coats covered by a thin membrane. The surgical procedure consisted of adhesiolysis with the release of the loops. The fibrous nature of the membrane on histology and the negativity of the etiological examinations allowed the diagnosis to be retained.

Clinical discussion

This is the result of a chronic attack on the peritoneum. In the majority of cases, it is said to be secondary because it occurs in a known evocative context. However, idiopathic cases have been reported. The disease has an insidious course making its diagnosis difficult. The disease is associated with a high mortality rate even under treatment, which reflects its severity. There is no consensus on the therapeutic management of this disease.

Conclusion

Encapsulating peritonitis is a rare and serious disease with a difficult diagnosis and complex management. There is no consensus on the therapeutic management of this disease.

简介及重要性:包封性腹膜炎是一种罕见的慢性腹膜疾病。最常见的是继发性，它可以发生在没有任何预测因素的特发性。诊断常常被延误，治疗也不被规范。作者报告了一例囊性腹膜炎患者在医院在多哥。他们的病例突出了囊性腹膜炎的诊断困难。病例介绍一位46岁女性患者，有一过性腹痛病史，因急性肠梗阻入院急诊。需要剖腹手术。术中，发现有一层薄膜覆盖的涂层凝集。手术过程包括粘连松解和松解环。组织学上膜的纤维性质和病原学检查的阴性使诊断得以保留。临床讨论这是腹膜慢性发作的结果。在大多数情况下，它被认为是次要的，因为它发生在一个已知的唤起上下文。然而，也有特发性病例的报道。这种疾病病程隐匿，诊断困难。即使在治疗下，该病的死亡率也很高，这反映了其严重性。对于这种疾病的治疗管理尚无共识。结论囊性腹膜炎是一种罕见、严重、诊断困难、治疗复杂的疾病。对于这种疾病的治疗管理尚无共识。

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引用次数: 0

Eventration of diaphragm of unknown cause: A case report 原因不明的横膈膜外翻1例

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100653

Amartya Dahal, Yadvinder Singh, Ajmat Ansari, Robin Man Karmacharya, Satish Vaidya, Swechha Bhatt

Introduction and importance

Diaphragmatic eventration is a rare disorder with partial or complete thinning of diaphragmatic musculature. The fibroelastic hemidiaphragm, which is pliable, moves paradoxically upward during inspiration resulting in restrictive pulmonary function. It occurs as a result of congenital defect in the diaphragm or secondarily due to phrenic nerve injury. Most patients remain asymptomatic for a long duration—the disease is therefore underdiagnosed. However, in cases of clinical suspicion, chest radiography should be performed, which can be further confirmed by chest computed tomography (CT).

Case presentation

We present a case of a 67-year-old male with a right sided diaphragmatic eventration presenting as severe coughing for two months. Surgical plication of right hemidiaphragm was done in multilayer with percutaneous dynamic stabilization (PDS) yielding good outcome.

Clinical discussion

The decision on performing a surgical repair of the defect depends upon the extent of the complications. Symptomatic patients with compromised respiratory, cardiovascular or gastrointestinal function usually require the plication of the diaphragm.

Conclusion

Despite the rarity of the disease, clinicians must always evaluate the patient for diaphragmatic eventration to ensure early repair of the defect.

前言及重要性膈肌膨出是一种少见的膈肌部分或完全变薄的疾病。纤维弹性半隔膜是柔韧的，吸气时矛盾地向上移动，导致肺功能受限。它的发生是由于先天性膈缺损或继发由于膈神经损伤。大多数患者在很长一段时间内都没有症状，因此这种疾病没有得到充分诊断。但临床怀疑时，应行胸片检查，胸片可通过胸部CT进一步证实。我们报告一例67岁男性右侧膈肌脱位，表现为严重咳嗽两个月。采用多层经皮动态稳定(PDS)技术对右半膈进行手术治疗，效果良好。临床讨论对缺损进行手术修复的决定取决于并发症的程度。有症状的呼吸、心血管或胃肠功能受损的患者通常需要应用膈肌。结论尽管这种疾病很少见，临床医生必须经常评估患者的膈外翻，以确保早期修复缺损。

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引用次数: 0

Female house surgeon stabbed to death: High time for a multi-pronged action plan to prevent and manage violence against Health care workers 女家庭外科医生被刺死：是时候制定多管齐下的行动计划来预防和管理针对医护人员的暴力行为了

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100650

Mohammad Jawed Quereishi, ArunSundar MohanaSundaram , Avishek Koley, Dionisio Lorenzo Lorenzo-Villegas, Md Aminul Islam

引用次数: 0

Unravelling two fungal meningitis outbreaks in Mexico: An urgent call for multi-faceted action 揭开墨西哥两起真菌性脑膜炎疫情的面纱：紧急呼吁采取多方面行动

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100659

ArunSundar MohanaSundaram, Josef Finsterer, Dionisio Lorenzo Lorenzo-Villegas, Man Mohan Mehndiratta, Md Aminul Islam

引用次数: 0

Duodenal Strongyloides stercoralis infection in a 56-year old male: A case report 56岁男性十二指肠粪圆杆菌感染1例

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100651

James J. Yahaya, Emmanuel D. Morgan, Emmanuel Othieno

Introduction and importance

The infection caused by Strongyloides stercoralis (S stercoralis) is usually an asymptomatic condition particularly in immunocompetent individuals and the condition may remain unnoticed even for decades, however, strongyloidiasis is more severe in patients who are immunocompromised.

Case presentation

The patient is a 56-year old male who presented with nine months history of episodes of abdominal pain, nausea loss of appetite, and chronic diarrhea. His diarrhea had mucus and trace blood. His oesophagogastroduodenoscopy (OGD) revealed erythematous, hypertrophied, and ulcerating lining mucosa of the duodenum. The specimen sampled showed sections of the duodenum with numerous Strongyloides stercoralis larvae, some inside the crypts with associated active duodenitis.

Clinical discussion

Despite the asymptomatic nature of Strongyloides stercoralis infectious condition especially for immunocompetent patients, the infection may sometimes result into serious complications including exudative enteropathy and paralytic ileus. The clinical outcome of patients with strongyloidiasis is usually better despite severe infection may develop and it is associated with slightly increased morbidity and even mortality.

Conclusion

Diagnosis of Strongyloides stercoralis infection in individuals residing in tropical or subtropical countries who present with chronic diarrhea, abdominal pain should always be considered so as to avoid delay of diagnosis. This may help in preventing unnecessary complication such as severe anaemia, intestinal perforation or even death.

由粪类圆线虫(S stercoralis)引起的感染通常是一种无症状的疾病，特别是在免疫能力强的个体中，这种疾病可能会被忽视几十年，然而，在免疫功能低下的患者中，类圆线虫病更为严重。患者56岁，男性，腹痛、恶心、食欲不振、慢性腹泻9个月。他的腹泻有黏液和微量血。他的食管胃十二指肠镜(OGD)显示十二指肠粘膜内膜有红斑、肥大和溃疡。标本显示十二指肠切面有大量粪圆线虫幼虫，其中一些位于隐窝内，伴有活动性十二指肠炎。尽管粪类圆线虫感染的无症状性，特别是对免疫能力强的患者，感染有时会导致严重的并发症，包括渗出性肠病和麻痹性肠梗阻。尽管可能发生严重的感染，但类圆线虫病患者的临床结果通常较好，并且与发病率甚至死亡率略有增加有关。结论居住在热带或亚热带国家的患者，如果出现慢性腹泻、腹痛，应及时诊断粪类圆线虫感染，以免延误诊断。这可能有助于预防不必要的并发症，如严重贫血、肠穿孔甚至死亡。

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引用次数: 0

Parathyroid adenoma mimicking bethesda class III follicular thyroidal lesion: A case report 模仿Bethesda III类滤泡性甲状腺病变的甲状旁腺腺瘤1例报告

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100612

Caspar J. Peterson , Jennifer M. Klasen , Lukas Bubendorf , Martin Freitag , Tarik Delko , Ioannis I. Lazaridis

Introduction and importance

Although the majority of thyroid lesions are benign, diagnostic workup including fine needle aspiration biopsy cytology is important to rule out cancerous lesions. However, cytological findings may pose challenges in interpretation because of similarities in cytomorphological features between certain thyroid nodules and parathyroid tissue. Similarly, parathyroid lesions may go unnoticed for a long period of time because they are misinterpreted as thyroid lesions and patients with parathyroid lesions are typically oligo- or asymptomatic for a long period of time.

Case presentation

We present the case of a 57-year-old female patient who was under observation for a hormone inactive mildly suspicious thyroid nodule for eight years before the suspected thyroid nodule was found to be a parathyroid adenoma. Repeated fine needle aspiration biopsies showed cytomorphological features of Bethesda Class III thyroid nodules and the patient was asymptomatic throughout all consultations. Finally, a pathological hip fracture and symptomatic kidney stone prompted further diagnostic work-up, confirming primary hyperparathyroidism and exposing the suspected thyroid lesion for a parathyroid adenoma. After focused parathyroidectomy the patient fully recovered.

Clinical discussion

Systematic blood sampling for Calcium and parathyroid hormone levels, which has to become part of the usual work up for suspicious thyroid nodules, may have exposed the diagnosis earlier preventing secondary complications.

Conclusion

This case highlights one of the major pitfalls in ultrasound interpretation and fine needle aspiration biopsy of the thyroid gland. Physicians need to be aware of these difficulties during the diagnostic work-up.

虽然大多数甲状腺病变是良性的，但包括细针穿刺活检细胞学在内的诊断检查对于排除癌性病变很重要。然而，由于某些甲状腺结节和甲状旁腺组织的细胞形态学特征相似，细胞学结果可能在解释上带来挑战。同样，甲状旁腺病变可能在很长一段时间内被忽视，因为它们被误解为甲状腺病变，甲状旁腺病变患者通常在很长一段时间内无症状或无症状。我们报告一个57岁的女性患者，她因一个激素不活跃的轻度可疑甲状腺结节被观察了8年，后来发现疑似甲状腺结节为甲状旁腺瘤。反复细针穿刺活检显示Bethesda III类甲状腺结节的细胞形态学特征，患者在所有会诊期间均无症状。最后，病理性髋部骨折和症状性肾结石促使进一步的诊断检查，确认原发性甲状旁腺功能亢进，并暴露疑似甲状腺病变为甲状旁腺瘤。集中甲状旁腺切除术后，患者完全康复。临床讨论系统抽血检查钙和甲状旁腺激素水平，这已成为可疑甲状腺结节的常规检查的一部分，可能有助于早期诊断，预防继发性并发症。结论本病例突出了甲状腺超声诊断和细针穿刺活检的主要缺陷之一。在诊断过程中，医生需要意识到这些困难。

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引用次数: 0

Comparative efficacy of apneic oxygenation with face mask versus face mask alone pre-oxygenation to Prevent desaturation during endotracheal intubation of elective Pediatric surgical patients at St. Peter hospital, Addis Ababa Ethiopia:A single center prospective cohort study 埃塞俄比亚亚的斯亚贝巴圣彼得医院择期儿科手术患者气管插管期间面罩与面罩预充氧预防去饱和的疗效比较:一项单中心前瞻性队列研究

IF 1 Q3 Medicine

International Journal of Surgery Open

Pub Date : 2023-08-01 DOI: 10.1016/j.ijso.2023.100654

Ashenafi Seifu Gesso, Tsion Lemma Regasa, Eyayalem Melese Goshu, Lemlem Getachew Woldemariam, Mulualem Sitot Fekede

Background

Apneic oxygenation using a nasal cannula is used to deliver oxygen continuously during the apneic period of endotracheal intubation to prevent desaturation. Pre-oxygenation using face mask alone technique may be insufficient to provide a safe apnea period in pediatric patients who are at high risk for rapid desaturation compared to added apneic oxygenation. This study compared the efficacy of apneic oxygenation with a face mask (AO) versus a face mask alone (FMA) pre-oxygenation to prevent desaturation during endotracheal intubation in elective pediatric surgical patients.

Methods

A prospective cohort study was conducted on two equal groups of elective pediatric patients observed in either use of apneic oxygenation with a face mask (AO) or face mask alone(FMA) pre-oxygenation during endotracheal intubation at the study hospital from early December 2021 to late March 2022. The data were collected using a structured questionnaire. The primary outcome variable was the desaturation SpO₂ (<94%) observed during endotracheal intubation. The categorical data were analyzed using a χ2-test. Parametric data were analyzed using an independent t-test or one-way ANOVA as appropriate with a 95% CI and a p-value of < 0.05 was considered statistically significant. The Bonferroni post hoc analysis was employed to test the significance of means between the groups.

Results

The mean desaturation level was (SpO₂ = 95.74 ± 2.99) in apneic oxygenation with face-mask group and (SpO₂ = 93.96 ± 3.74) in the face-mask alone group(p = 0.006) with medium effect size (Cohan's d = 0.06). A one-way ANOVA showed a statistically significant difference in the mean (±SD) of desaturation level with the number of attempts at endotracheal intubation within the groups (P = 0.005). The Bonferroni pairwise comparison within groups, showed that the mean (±SD) desaturation level during endotracheal intubation for the participant with >2 attempts is significantly lower than for participants with only 1 attempt (p-value = 0.004).

Conclusion and recommendation

A continuous administration of apneic oxygenation (5-l/min) by nasal cannula during endotracheal intubation significantly reduced desaturation in pediatrics. We recommend the use of apneic oxygenation (AO) in pediatrics during intubation time.

背景:在气管插管的呼吸暂停期间，使用鼻导管进行呼吸供氧，以防止缺氧。单独使用面罩预充氧技术可能不足以为儿科患者提供安全的呼吸暂停期，与增加呼吸暂停氧合相比，儿童患者具有快速去饱和的高风险。本研究比较了面罩(AO)与面罩(FMA)预充氧在预防选择性儿科手术患者气管插管期间失饱和的效果。方法前瞻性队列研究于2021年12月初至2022年3月下旬在研究医院对两组均等的选择性儿科患者进行气管插管期间使用面罩(AO)或面罩(FMA)预充氧的观察。数据是通过结构化问卷收集的。主要结局变量为气管插管期间观察到的去饱和SpO2(94%)。分类资料采用χ2检验进行分析。参数数据分析采用独立t检验或单因素方差分析，CI为95%，p值为<0.05认为有统计学意义。采用Bonferroni事后分析检验组间均值的显著性。结果面罩组的平均去饱和水平为(SpO2 = 95.74±2.99)，单纯面罩组的平均去饱和水平为(SpO2 = 93.96±3.74)(p = 0.006)，效应大小中等(Cohan’s d = 0.06)。单因素方差分析显示，两组患者去饱和水平平均值(±SD)与气管插管次数的差异有统计学意义(P = 0.005)。组内Bonferroni两两比较显示，2次尝试者气管插管时的平均(±SD)去饱和水平显著低于1次尝试者(p值= 0.004)。结论和建议在小儿气管插管时通过鼻插管持续给氧(5-l/min)可显著降低血氧饱和度。我们建议在儿科插管期间使用呼吸暂停氧合(AO)。

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引用次数: 0