血管造影在玻璃体切除术患者安全镇静中的作用

Sinem Ozpar, Selcan Akesen, F. Kahveci
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摘要

目的:评价在常规监测中加入血氧饱和度、低氧血症及其他生命参数监测的有效性。方法:选取100例在镇静下行择期玻璃体切除术的成年患者作为研究对象。将患者分为“实验组”(在常规监测的基础上加摄血糖)和“对照组”(在常规监测的基础上不加摄血糖)。低氧血症,去饱和,心动过速,心动过缓,气道额外操作进行比较。测定实验组患者潮末二氧化碳(EtCO2)水平、低氧血症、去饱和、综合肺指数(IPI)需要注意(5-7)和干预(1-4)的升高和降低情况,并评估其发生频率。结果:实验组去饱和率、心动过缓率及计数明显低于对照组。两组之间在低氧血症、心动过速和额外动作方面没有显著差异。实验组患者EtCO2降低76%(38/50),EtCO2升高10%(5/50),呼吸暂停38%(19/50),IPI需注意52%(26/50),IPI需干预14%(7/50)。结论:在镇静玻璃体切除术患者常规监测的基础上增加血管造影,可减少氧饱和度过低和心动过缓的发生,并可及时随访EtCO2、呼吸暂停和IPI水平;呼吸抑制可在氧饱和度下降前被识别。
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ROLE OF CAPNOGRAPHY IN SAFE SEDATION OF VITRECTOMY PATIENTS
Purpose: To evaluate the efficiency of the capnography monitoring added to routine monitoring on oxygen desaturation, hypoxemia, and other vital parameters. Methods: 100 adult patients who had elective vitrectomy under sedation were included in this study. Patients were divided into “experiment”(capnography added to routine monitoring) and “control”(capnography not added to routine monitoring) groups. Hypoxemia, desaturation, tachycardia, bradycardia, additional maneuvers for the airway were compared. Increase and decrease in end-tidal carbon dioxide (EtCO2) levels, hypoxemia, desaturation, Integrated Pulmonary Index (IPI) levels requiring attention (5-7), and intervention (1-4) were determined in the experiment group, and frequencies of them were assessed. Results: Desaturation and bradycardia rates and counts in the experiment group were significantly lower than the control group. No significant difference was seen between groups in terms of hypoxemia, tachycardia, and additional maneuvers. 76%(38/50) of experiment group patients had decrease in EtCO2, 10%(5/50) increase in EtCO2, 38%(19/50) apnea, 52%(26/50) IPI levels requiring attention, 14%(7/50) IPI levels requiring intervention. Conclusion: With addition of the capnography to routine monitoring of sedated vitrectomy patients, oxygen desaturation and bradycardia can be less likely to occur, and with instant follow-up of the EtCO2, apnea, and IPI levels; respiratory depression can be recognized before oxygen desaturation develops.
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