改良T组合复苏器与鼻导管吸氧用于婴儿电子支气管镜检查的安全性比较：一项前瞻性随机对照研究

Safety of modified T-piece resuscitator versus nasal cannula oxygen in electronic bronchoscopy for infants: a prospective randomized controlled study

摘要:

目的 优化肺部疾病婴儿接受支气管镜检查时的氧疗方案。方法 该研究是一项前瞻性随机、对照的单中心临床试验。前瞻性选择2019年7月—2021年7月42例接受电子支气管镜检查的婴儿为研究对象。按照随机数字表法分为鼻导管吸氧（nasal cannula oxygen, NC）组及改良T组合复苏器（T-piece resuscitator, TPR）组。记录两组术中最低血氧饱和度结果作为主要指标，术中心率及呼吸结果作为次要指标。结果 改良TPR组术中最低血氧饱和度高于NC组，低氧血症发生率低于NC组（P<0.05）；改良TPR组术中有6例患儿轻度低氧、2例中度低氧及1例重度低氧，NC组分别有3、5和9例，差异有统计学意义（P<0.05）。改良TPR组术中呼吸节律异常发生率低于NC组（P<0.05），两组心律失常发生率差异无统计学意义（P>0.05）。结论 改良TPR可以显著减少肺部疾病婴儿接受电子支气管镜时发生低氧血症的风险；与传统NC相比，TPR可明显改善低氧血症的严重程度，且减少呼吸节律异常的发生率。

Abstract:

Objective To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy.Methods A prospective randomized, controlled, and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021. These infants were divided into a nasal cannula (NC) group and a modified T-piece resuscitator (TPR) group using a random number table. The lowest intraoperative blood oxygen saturation was recorded as the primary outcome, and intraoperative heart rate and respiratory results were recorded as the secondary outcomes.Results Compared with the NC group, the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia (P<0.05). In the modified TPR group, there were 6 infants with mild hypoxemia, 2 with moderate hypoxemia, and 1 with severe hypoxemia, while in the NC group, there were 3 infants with mild hypoxemia, 5 with moderate hypoxemia, and 9 with severe hypoxemia (P<0.05). The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group (P<0.05), but there was no significant difference in the incidence rate of arrhythmias between the two groups (P>0.05).Conclusions Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy, and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.