目的:气体栓塞是宫腔镜手术的常见并发症,由于对患者的潜在风险,引起妇科医生和麻醉师的严重关注。宫腔镜手术中影响气体栓塞的因素已被广泛研究。然而,宫腔镜手术期间患者吸入的氧气浓度对气体栓塞的影响仍然难以捉摸。因此,我们设计了双盲,随机化,对照试验确定不同的吸入氧浓度是否影响宫腔镜手术期间气体栓塞的发生。
方法:本试验纳入162例接受宫腔镜手术的成年患者,随机分为3组,吸入氧分数为30%,50%,和100%。经胸超声心动图(四腔视图)用于评估是否发生气体栓塞。手术开始前,连续监测四腔视图.
结果:30%的气体栓塞数量,50%,100%组为36(69.2%),30(55.6%),和24(44.4%),分别。随着吸入氧浓度的增加,气体栓塞的发生率逐渐降低(P=0.031)。
结论:在宫腔镜手术中,患者吸入较高的氧气浓度可能会降低气体栓塞的发生率,表明吸入的氧气浓度较高,尤其是100%,可推荐用于宫腔镜手术期间的患者。
背景:中国临床试验注册中心(https://www.chictr.org.cn/showproj.html?proj=53779,注册号:ChiCTR2000033202)。
OBJECTIVE: Gas embolism is a common complication of hysteroscopic surgery that causes serious concern among gynecologists and anesthesiologists due to the potential risk to patients. The factors influencing gas embolism in hysteroscopic surgery have been extensively studied. However, the effect of the oxygen concentration inhaled by patients on gas embolism during hysteroscopic surgery remains elusive. Therefore, we designed a double-blind, randomized, controlled trial to determine whether different inhaled oxygen concentrations influence the occurrence of gas embolism during hysteroscopic surgery.
METHODS: This trial enrolled 162 adult patients undergoing elective hysteroscopic surgery who were randomly divided into three groups with inspired oxygen fractions of 30%, 50%, and 100%. Transthoracic echocardiography (four-chamber view) was used to evaluate whether gas embolism occurred. Before the start of surgery, the four-chamber view was continuously monitored.
RESULTS: The number of gas embolisms in the 30%, 50%, and 100% groups was 36 (69.2%), 30 (55.6%), and 24 (44.4%), respectively. The incidence of gas embolism gradually decreased with increasing inhaled oxygen concentration (P = 0.031).
CONCLUSIONS: In hysteroscopic surgery, a higher oxygen concentration inhaled by patients may reduce the incidence of gas embolism, indicating that a higher inhaled oxygen concentration, especially 100%, could be recommended for patients during hysteroscopic surgery.
BACKGROUND: Chinese Clinical Trial Registry (https://www.chictr.org.cn/showproj.html?proj=53779, Registration number: ChiCTR2000033202).