摘要
目的回顾性分析硬式支气管镜下气管、支气管肿瘤冷冻治疗中高频喷射通气（HFJV）临床应用的有效性和安全性。方法收集中日友好医院2008年8月至2015年2月35例HFJV下经硬式支气管镜行气管肿瘤冷冻治疗患者的临床资料，所有患者均在全身麻醉下行HFJV，记录术中平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）、血气分析以及术中相关并发症的发生率。结果35例患者中，有1例多次行气管冷冻术，第2次手术时，HFJV通气40 min后出现气道痉挛，行气管插管；第3次行手术时，HFJV通气5 min后，SpO2降至70%，遂行气管插管；该患者术中出现严重CO2蓄积，动脉血二氧化碳分压（PaCO2 ）为71 mmHg（1 mmHg＝0.133 kPa）。其余患者术中血压、心率平稳，未出现严重CO2蓄积。结论经硬式支气管镜行气管、支气管终末期肿瘤冷冻治疗中，高频喷射通气技术可提供满意的通气效果。
ObjectiveTo analyze the clinical applications of high frequency jet ventilation（HFJV） in cryotherapy of the trachea and bronchial neoplasms by the rigid bronchoscope.Methods The clinical data of 35 patients who were treated with tracheal neoplasms cryotherapy by the rigid bronchoscopy under HFJV were collected in China-Japan Friendship Hospital from August 2008 to February 2015.Under general anesthesia, HFJV was used in all patients. The mean arterial pressure （MAP）, heart rates （HR）, pulse oxygen saturation （SpO2）, results of arterial blood gas analysis and the incidence of complications during the procedure were recorded.Results In the 35 patients, one case had multiple operations experience, he had an airway spasm after HFJV 40 min during his second operation, and severe hypoxemia after HFJV 5 min during his third operation, endotracheal intubation was performed immediately. The patient has a serious accumulation of carbon dioxide （CO2） whose partial pressure of carbon dioxide in the artery （PaCO2） was up to 71 mmHg（1 mmHg=0.133 kPa）. Other patients had stable hemodynamics and no severe CO2 accumulation.Conclusion High frequency jet ventilation can provide satisfactory ventilation effect in cryotherapy of the trachea and bronchial end-stage neoplasms by the rigid bronchoscope.
作者
牛学功
刘鲲鹏
任宪凤
李健
Niu Xuegong;Liu Kunpeng;Ren Xianfeng;Li Jian(Department of Anesthesiology, Beijing Tongren hospital, Capital Medical University,Beijing 100730, China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第24期1941-1944,共4页
National Medical Journal of China
关键词
高频喷射通气
气管肿瘤
冷冻疗法
High frequency jet ventilation
Tracheal neoplasms
Cryotherapy
