Zhongguo cuzhong zazhi (Oct 2024)
不同供氧方式高压氧治疗对手术治疗后卒中患者经皮氧分压影响的研究Effects of Different Oxygen Supply Methods during Hyperbaric Oxygen Therapy on the Transcutaneous Oximetry of Post-Surgery Stroke Patients
Abstract
目的 评估不同供氧方式的高压氧治疗下，发病30 d内卒中术后患者经皮氧分压（transcutaneous oximetry，TcPO2）的变化。 方法 回顾性纳入2023年1月1日—2024年6月20日在高压氧科接受治疗的发病30 d内卒中术后患者，根据气道情况分为正常气道面罩加储气囊供氧（面罩组）和人工气道头罩供氧（头罩组）。高压氧治疗期间实时监测TcPO2，比较两种供氧方式下TcPO2变化。 结果 本研究共入选26例患者，面罩组和头罩组各13例。面罩组升压开始时TcPO2为（55.92±9.58）mmHg （1 mmHg=0.133 kPa），稳压吸氧阶段TcPO2平均值和最大值分别为（679.30±186.80）mmHg和（881.40±208.20）mmHg，减压结束TcPO2为（83.71±21.54）mmHg。头罩组升压开始时TcPO2为（62.92±14.84）mmHg，稳压吸氧阶段TcPO2平均值和最大值分别为（369.50±163.00）mmHg和（487.90±212.10）mmHg，减压结束TcPO2为（84.25±19.95）mmHg。面罩组稳压吸氧阶段TcPO2的平均值和最大值高于头罩组相应指标，差异有统计学意义（P<0.01）。面罩组和头罩组稳压吸氧10 min TcPO2开始升高，面罩组吸氧30 min TcPO2达到饱和，头罩组随吸氧时间延长TcPO2动态上升直至吸氧结束。 结论 高压氧治疗期间，面罩供氧和头罩供氧均能提升卒中术后患者的TcPO2水平，面罩吸氧效果应该优于头罩。 Abstract: Objective To evaluate the changes in transcutaneous oximetry (TcPO2) within 30 days of stroke onset in post-surgery patients under hyperbaric oxygen therapy with different oxygen supply methods. Methods Post-surgery stroke patients who received treatment in the hyperbaric oxygen department within 30 days of onset from January 1, 2023 to June 20, 2024 were included in this retrospective analysis. According to the airway condition, normal airway patients were supplied with a mask and reservoir bag (the mask group) and artificial airway patients with ventilator weaning were supplied with a head hood (the head hood group). The TcPO2 was monitored in real time during hyperbaric oxygen therapy and compared the changes of TcPO2 between the two oxygen supply methods. Results A total of 26 patients were included in this study, including 13 patients in the mask group and 13 patients in the head hood group. In the mask group, TcPO2 was (55.92±9.58) mmHg (1 mmHg=0.133 kPa) before compression, and the mean and maximum TcPO2 during oxygen inhalation stage were (679.30±186.80) mmHg and (881.40±208.20) mmHg, respectively. After decompression, TcPO2 was (83.71±21.54) mmHg. In the head hood group, TcPO2 was (62.92±14.84) mmHg before compression, the mean and maximum TcPO2 during oxygen inhalation stage were (369.50±163.00) mmHg and (487.90±212.10) mmHg, respectively. After decompression, TcPO2 was (84.25±19.95) mmHg. The mean and maximum of TcPO2 during oxygen inhalation stage in the mask group were higher than those in the head hood group, and the differences were statistically significant (P<0.01). The TcPO2 of the mask group and the head hood group began to increase after oxygen inhalation for 10 minutes. In the mask group, TcPO2 reached the saturation at 30 minutes, while in the hood group, TcPO2 increased dynamically with the extension of oxygen inhalation time until the end of oxygen inhalation. Conclusions During hyperbaric oxygen therapy, both mask oxygen supply and head hood oxygen supply increased the TcPO2 level of post-surgery stroke patients, and the oxygen inhalation effect of mask should be better than that of head hood.
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