摘要
目的比较口咽通气导管与鼻咽通气导管间歇性高频喷射通气(IHFJV)用于肺炎患者无痛电子支气管镜检查术(PLVB)辅助通气的效果。方法择期行PLVB的肺炎患者160例,性别不限,年龄46~64岁,BMI 18~29 kg/m^(2),ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组(n=80):鼻咽通气导管组(N组)和口咽通气导管组(O组)。N组置入内径4.0 mm的鼻咽通气导管,O组置入内径4.0 mm的口咽通气导管,行IHFJV,I∶E 1∶3,喷射频率100次/min,喷射峰压0.4 kPa,潮气量160 ml,每间歇2 min给予5次喷射:I∶E 1∶3,喷射频率20次/min,喷射峰压0.4 kPa,潮气量300 ml。分别于术前20 min(T_1)、手术开始5 min(T_2)、术毕即刻(T_3)和术后5 min(T_4)时记录SpO2。于T_1、T_3和T_4时采集动脉血样行血气分析。记录检查期间托下颌、面罩加压通气、呛咳、气道痉挛、导管脱落或移位和体动的发生情况。结果与N组比较,O组T_3时SpO2和PaO2升高,T_3,4时A-aDO2降低,提下颌、呛咳和导管脱出或移位发生率降低(P<0.05)。结论口咽通气导管IHFJV用于肺炎患者PLVB辅助通气的效果优于鼻咽通气导管。
Objective To compare the efficacy of intermittent high-frequency jet ventilation(IHFJV)mediated by oropharyngeal ventilation catheter versus nasopharyngeal ventilation catheter for assisted ventilation in the patients with pneumonia undergoing painless electronic bronchoscopy(PLVB).Methods One hundred and sixty patients of both sexes with pneumonia,aged 46-64 yr,with body mass index of 18-29 kg/m^(2),of American Society of Anesthesiologists physical statusⅠorⅡ,undergoing elective PLVB,were divided into 2 groups(n=80 each)using a random number table method:nasopharyngeal ventilation catheter group(N group)and oropharyngeal ventilation catheter group(O group).A nasopharyngeal ventilation catheter 4.0 mm in inner diameter was inserted in group N,and an oropharyngeal ventilation catheter 4.0 mm in inner diameter was inserted in group O to perform IHFJV,with I∶E 1∶3,injection frequency 100 times/min,peak pressure 0.4 kPa,and tidal volume 160 ml,and five injections were given every 2 min with I∶E 1∶3,frequency 20 times/min,injection peak pressure 0.4 kPa,and tidal volume of 300 ml.T_he physiological indexes(SpO2)was recorded at 20 min before operation(T_1),5 min after start of operation(T_2),immediately after the end of operation(T_3),and 5 min after operation(T_4).Arterial blood samples were collected at T_1,T_3 and T_4 for blood gas analysis.T_he occurrence of jaw support,mask pressure ventilation,bucking,airway spasm,catheter shedding or displacement,and body movement were recorded.Results Compared with group N,the SpO2 and PaO2 were significantly increased at T_3,A-aDO2 was decreased at T_3,4,and the incidence of jaw support,bucking and catheter prolapse or displacement was decreased in group O(P<0.05).Conclusion IHFJV mediated by oropharyngeal ventilation catheter provides better efficacy when used for assisted ventilation than that mediated by nasopharyngeal ventilation catheter in patients with pneumonia undergoing PLVB.
作者
田海涛
黄宇光
王文荣
许崇晓
李海鸥
丁超
宋成伟
Tian Haitao;Huang Yuguang;Wang Wenrong;Xu Chongxiao;Li Haiou;Ding Chao;Song Chengwei(Department of Anesthesiology,Jining First People′s Hospital,272111 Jining,Shandong Province,China;Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical,Beijing 100730,China;Chinese Center for Disease Control and Prevention,Beijing 102200,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2020年第10期1224-1227,共4页
Chinese Journal of Anesthesiology
基金
山东省重点研发计划项目(2018GSF118216)
山东省医药卫生科技发展计划项目(2017WS524)。
关键词
高频喷射通气
支气管镜检查
肺炎
通气导管
High-frequency jet ventilation
Bronchoscopy
Pneumonia
Ventilation catheter
