Effect Analysis of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange in Painless Endoscopic Mucosal Resection of Colorectal Polyps
Objective To analyze the safety and feasibility of transnasal humidified rapid-insufflation ventilatory exchange(THRIVE)during painless endoscopic mucosal resection of colorectal polyps.Meth-ods A total of 80 patients with colorectal polyps who were scheduled to receive painless endoscopic muco-sal resection in our hospital from November 2021 to November 2023 were selected and divided into control group and observation group by computer random number table method,with 40 cases in each group.Pa-tients in the control group received conventional nasal oxygen inhalation during the operation,while pa-tients in the observation group received THRIVE during the operation.Perioperative hemodynamic inde-xes of heart rate(HR),blood oxygen saturation(SpO2),pH value,partial pressure of carbon dioxide(PaCO2)and arterial oxygen partial pressure(PaO2),occurrence and treatment of anoxia events during anesthesia,occurrence of other adverse events,as well as operation time,intraoperative propofol dosage and postoperative recovery time were compared between the two groups.Results 1)Hemodynamic in-dexes:Compared with the preoperative resting time of 5 min(T0),HR in both groups decreased signifi-cantly 1 min after entry of endoscope(T1)and entry to ileocecal valve(T2),and recovered to the preoper-ative level at the end of operation(T3).There was no statistical significance in HR between the two groups at the same time point(P＞0.05).SpO2 did not fluctuate significantly at T0,T1,T2 and T3 in the observation group(P＞0.05).SpO2 in the control group at T1 was significantly lower than that at T0(P＜0.05),and was significantly lower than that in the observation group at the same time(P＜0.05).PaCO2 did not fluctuate significantly at T0,T2 and T3 in the observation group(P＞0.05).PaCO2 at T2 and T3 in the control group was significantly higher than that at T0(P＜0.05),and signifi-cantly lower than that at the same time in the observation group(P＜0.05).PaO2 at T2 and T3 in both groups was significantly higher than that at T0(P＜0.05),but there was no significant difference be-tween groups(P＞0.05).There was no significant change in pH value at T0,T2 and T3 in both groups(P＞0.05).2)Occurrence and treatment of hypoxia events:The incidence of subclinical respiratory de-pression(7.50％)and hypoxia(0)in the observation group was lower than that in the control group(20.00％,12.50％)(P＜0.05).Except for 1 case of severe hypoxia in the control group,all patients with hypoxia events in both groups were relieved by opening the airway and supporting the lower jaw.3)Occurrence of other adverse events:There were no statistically significant differences in the incidence of gastric intake of air,bradycardia,hypotension,hypertension,reflux,aspiration,agitation,postoperative nausea and vomiting between the two groups(P＞0.05).4)Surgical indexes:There were no significant differences in operation time,intraoperative propofol dosage and postoperative recovery time between the two groups(P＞0.05).Conclusion In the painless endoscopic mucosal resection of colorectal polyps,THRIVE is helpful to stabilize the hemodynamic indexes of patients,reduce the incidence of hypoxia events without increasing other adverse events,and improve the surgical safety.
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