背景:鼻插管和面罩是常规氧疗中常用的充氧工具,适用于内窥镜手术并进行镇静的患者。然而,作为一种新颖的声门上通气技术,声门上喷射氧合和通气(SJOV)在内窥镜手术中的应用尚未得到很好的证实.
方法:从开始到2024年1月16日,我们搜索了六个电子数据库,以评估SJOV在内窥镜手术中的氧合/通气功效和副作用。主要结果是低氧血症的发生率。次要结果是呼吸抑制和不良反应的发生率(鼻出血,喉咙痛,和口干)。
结果:纳入了9项涉及2017年患者的试验。结果表明,与常规氧疗(COT)组相比,SJOV组的低氧血症发生率较低[9个试验;2017年患者;风险比(RR)=0.18;95%置信区间(CI),(0.11-0.28)]。亚组分析显示,SJOV降低了高风险组低氧血症的发生率,但对低风险组没有影响。SJOV的呼吸抑制发生率低于COT,但增加了口干等副作用。两组在鼻出血或咽喉痛方面差异无统计学意义。
结论:与COT相比,SJOV降低了内镜手术和镇静期间高危患者低氧血症的发生率.口干的风险增加,但不是鼻出血或喉咙痛,在内窥镜手术中镇静。
BACKGROUND: Nasal cannulas and face masks are common oxygenation tools used in conventional oxygen therapy for patients undergoing endoscopic surgery with sedation. However, as a novel supraglottic ventilation technique, the application of supraglottic jet oxygenation and ventilation (SJOV) in endoscopic surgery has not been well established.
METHODS: We searched six electronic databases from inception to January 16, 2024, to assess the oxygenation/ventilation efficacy and side effects of the of SJOV in endoscopic surgery. The primary outcome was the incidence of hypoxemia. The secondary outcomes were the incidence of respiratory depression and adverse effects (nasal bleeding, sore throat, and dry mouth).
RESULTS: Nine trials involving 2017 patients were included. The results demonstrated that the incidence of hypoxemia was lower in the SJOV group compared with the conventional oxygen therapy (COT) group [9 trails; 2017 patients; risk ratio (RR) = 0.18; 95% confidence interval (CI), (0.11-0.28)]. Subgroup analyses showed that SJOV reduced the incidence of hypoxemia in the high-risk group but had no effect on the low-risk group. The incidence of respiratory depression is lower in SJOV than in COT, but has increased side effects such as dry mouth. There was no statistically significant difference in nose bleeding or sore throat between the two groups.
CONCLUSIONS: Compared with the COT, the SJOV decreased the incidence of hypoxemia in high-risk patients during endoscopic surgery with sedation. There was an increased risk of dry mouth, but not of nose bleeding or sore throat, during endoscopic surgery under sedation.