Comparative study on the nursing effects of high-flow nasal hydrated oxygen therapy and traditional mask oxygen inhalation during intravenous general anesthesia
高流量经鼻湿化氧疗与传统面罩吸氧在静脉全麻患者术中应用的护理效果比较研究

摘要

目的 比较研究静脉全麻手术治疗期间高流量经鼻湿化氧疗（HFNC）、传统面罩吸氧应用对患者围手术期循环系统功能影响性。方法 纳入2023年1月~2023年12月期间入院接受非插管静脉麻醉手术治疗患者（61例）为研究对象，开展对比性临床研究，术前取随机数字表法分组，予以对照组（31例）术中传统面罩吸氧支持，予以观察组（30例）HFNC吸氧支持。比较患者围手术期循环系统功能指标[平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）]，手术用时、术后苏醒用时，术中麻醉剂用量及吸氧支持相关不良事件发生率组间差异。结果 两组患者术前一般资料比较，差异无统计学意义（P>0.05）。在循环功能方面，观察组在病灶切除即刻和手术结束即刻的心率（HR）显著低于对照组（均P<0.05），且手术结束即刻的血氧饱和度（SpO₂）显著高于对照组（P<0.05）；然而，两组各时间点的平均动脉压（MAP）比较，差异均无统计学意义（均P>0.05）。观察组的术后苏醒时间显著短于对照组[（3.62±0.98）min vs （4.45±1.04）min，P=0.002]，但两组手术时间、丙泊酚及舒芬太尼用量差异无统计学意义（均P>0.05）。两组低氧血症等吸氧支持相关不良事件总发生率比较，差异无统计学意义[16.67%（5/30） vs 12.90%（4/31），P=0.679]。结论 HFNC及面罩吸氧均可应用于非插管静脉麻醉手术治疗，但就术中应用效果而言，HFNC对患者氧合、循环系统功能稳定性具有一定优势性，可酌情选择应用。

Abstract

Objective To compare the effects of high-flow nasal humidified oxygen therapy (HFNC) and traditional mask oxygen inhalation on perioperative circulatory function during surgical procedures under intravenous general anesthesia.
Methods A comparative clinical study was conducted in 61 patients undergoing non-intubated intravenous anesthesia between January 2023 and December 2023. Preoperatively, patients were randomly assigned to a control group (31 patients) who received traditional mask oxygen inhalation, while an observation group (30 patients) received HFNC oxygen inhalation. Differences in perioperative circulatory function parameters (mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2)), surgical duration, postoperative recovery time, intraoperative anesthetic dosage, and the incidence of adverse events related to oxygen inhalation were compared between the two groups.
Results No statistically significant differences were found in the preoperative general data between the two groups (P>0.05). In terms of circulatory function, the heart rate (HR) in the observation group was significantly lower immediately after lesion resection and immediately after surgery than in the control group (both P<0.05), and the blood oxygen saturation (SpO₂) immediately after surgery was significantly higher than that in the control group (P<0.05). However, no statistically significant differences were found in mean arterial pressure (MAP) at any time point between the two groups (both P>0.05). The postoperative recovery time in the observation group was significantly shorter than that in the control group [(3.62±0.98) min vs (4.45±1.04) min, P=0.002]. However, no statistically significant differences were found in the operative time, propofol dosage, and sufentanil dosage between the two groups (all P>0.05). The overall incidence of adverse events related to oxygen support, such as hypoxemia, was not statistically significantly different between the two groups [16.67% (5/30) vs 12.90% (4/31), P = 0.679].
Conclusion  s Both HFNC and face mask oxygen inhalation can be used for non-intubated intravenous anesthesia surgery. However, in terms of intraoperative efficacy, HFNC has certain advantages in improving patient oxygenation and circulatory system stability and can be used as appropriate.