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| 经鼻高流量氧疗对高海拔地区胸腔镜手术患者术后恢复质量的影响 |
| Effect of high-flow nasal cannula on postoperative recovery quality in patients undergoing thoracoscopic surgery at high altitude areas |
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| DOI：10.12089/jca.2026.02.001 |
| 中文关键词: 经鼻高流量氧疗 高海拔地区 术后恢复质量 麻醉恢复室 胸腔镜手术 |
| 英文关键词: High-flow nasal cannula High altitudes Postoperative recovery quality Post-anesthesia care unit Thoracoscopic surgery |
| 基金项目:西藏自然科学基金组团式援藏项目［XZ2021ZR-ZY15（Z）］ |
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| 中文摘要: |
目的：探讨经鼻高流量氧疗（HFNC）对高海拔地区胸腔镜手术患者术后恢复质量的影响。
方法：选择择期行全麻下胸腔镜手术的患者，年龄18～74岁，ASAⅠ—Ⅲ级。将患者随机分为两组：HFNC组（H组）和常规鼻导管组（S组）。在PACU内，H组接受HFNC治疗，40 L/min，FiO2 45%。S组给予鼻导管吸湿化纯氧6 L/min。两组均在转回病房后继续接受相应的氧疗至术后24 h。主要指标为PACU氧疗期间低氧血症的发生率。次要指标包括PACU留观时间、PACU氧疗期间SpO2及最低SpO2、病房期间SpO2、术后住院时间。不良反应包括术后肺不张、肺部感染、静脉血栓、再次插管事件。
结果：共纳入患者79例，S组40例，H组39例。与S组比较，H组PACU氧疗期间及病房期间低氧血症发生率明显降低，氧疗期间SpO2及最低SpO2、病房期间SpO2明显升高，术后肺不张和静脉血栓事件发生率明显降低，PACU留观时间和术后住院时间明显缩短（P＜0.05）。两组再次插管率和肺部感染等术后并发症发生率差异无统计学意义。
结论：在高海拔地区接受胸腔镜手术患者中，HFNC可显著降低术后低氧血症，改善氧合情况，降低肺不张等术后并发症的发生率，并缩短PACU留观时间和术后住院时间。 |
| 英文摘要: |
Objective: To investigate the effects of high-flow nasal cannula (HFNC) oxygen therapy on recovery quality in patients undergoing thoracoscopic surgery at high-altitude areas.
Methods: Patients scheduled for elective thoracoscopic surgery under general anesthesia were selected, aged 18-74 years, ASA physical status Ⅰ-Ⅲ. Patients were randomly assigned to two groups: the HFNC group (group H) and the standard nasal cannula group (group S). In the PACU, the group H received heated-humidified HFNC at a flow rate of 40 L/min with an FiO2 of 45% while group S received oxygen at 6 L/min with an FiO2 of 100% via nasal prongs. Both groups continued the respective oxygen therapy upon returning to the general ward until 24 hours postoperatively. The primary outcome was the incidence of hypoxemia during oxygen therapy in the PACU. Secondary outcomes included PACU length of stay, SpO2 and lowest SpO2 during PACU oxygen therapy, SpO2 on the ward, postoperative hospital stay. Adverse reactions included postoperative atelectasis, pulmonary infection, venous thrombosis, and reintubation events.
Results: Seventy-nine patients was finally included, 40 patients in group S and 39 patients in group H. Compared with group S, group H showed a significantly lower incidence of hypoxemia both during oxygen therapy in the PACU and on the ward, significantly improved SpO2 and lowest SpO2 during oxygen therapy, as well as room-air SpO2 on the ward. The rates of postoperative atelectasis and venous thrombosis were also significantly reduced, and both PACU stay and postoperative hospitalization were shortened (P < 0.05). However, the differences in reintubation rate and other complications such as pulmonary infection were not statistically significant between the two groups.
Conclusion: In patients undergoing thoracoscopic surgery at high-altitude areas, HFNC therapy can significantly reduce the incidence of postoperative hypoxemia, improve oxygenation, reduce the incidence of atelectasis, and shorten PACU observation time and postoperative hospitalization. |
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