摘要
目的对比研究叠加高频喷射通气(即高频‑常频叠加喷射通气)与高频喷射通气应用于无痛纤维支气管镜检查(fiberoptic bronchoscope,FOB)气道管理中的临床效果。方法择期行无痛FOB治疗的患者40例,按随机数字表法分为高频喷射通气组(H组)和高频‑常频叠加喷射通气组(S组),每组20例。患者麻醉诱导后置入喉罩,H组采用单纯高频喷射通气,S组采用高频‑常频叠加喷射通气。记录两组患者入室(T_(0)),高频‑常频叠加喷射通气或高频喷射通气15 min(T_(1))、30 min(T_(2)),恢复自主呼吸即刻(T_(3))时的心率、MAP、SpO_(2)、pH值、PaCO_(2)、PaO_(2)、血糖、皮质醇、C反应蛋白(C‑reactive protein,CRP)和IL‑6浓度;记录术中因P_(ET)CO_(2)>80 mmHg(1 mmHg=0.133 kPa)暂停手术操作的患者例数。结果两组患者均未见低氧血症发生。与T_(0)时比较:两组患者T_(2)、T_(3)时心率升高(P<0.05),T_(1)~T_(3)时SpO_(2)、PaO_(2)、IL‑6升高(P<0.05);H组T_(2)、T_(3)时MAP、血糖和皮质醇升高(P<0.05),T_(3)时CRP升高(P<0.05),T_(1)~T_(3)时pH值降低、PaCO_(2)升高;S组T_(3)时MAP、血糖和皮质醇升高(P<0.05),T_(2)时pH值降低(P<0.05)。与H组比较:S组T_(2)时心率和MAP降低(P<0.05),T_(1)~T_(3)时pH值升高、PaCO_(2)降低(P<0.05),T_(2)、T_(3)时血糖、皮质醇、IL‑6降低(P<0.05),T_(3)时CRP降低(P<0.05)。各指标其余时点间差异无统计学意义(P>0.05)。H组因术中P_(ET)CO_(2)>80 mmHg暂停操作的有3例,S组0例。结论在无痛FOB治疗气道管理中,高频‑常频叠加喷射通气效果优于单纯高频喷射通气。
Objective To compare the clinical effectiveness of superimposed high frequency jet ventilation and high‑frequency jet ventilation in airway management by fiberoptic bronchoscopy(FOB)under general anesthesia.Methods According to the random number table method,40 patients who were scheduled for painless FOB were randomly divided into two groups(n=20):high‑frequency jet ventilation group(group H)and a superimposed high frequency jet ventilation group(group S).After anesthesia induction,group H underwent high‑frequency jet ventilation,while group S received superimposed high frequency jet ventilation after general anesthesia with laryngeal mask.Their heart beat,mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))as well as pH value,partial pressure of arterial oxygen(PaO_(2))and arterial carbon dioxide partial pressure(PaCO_(2))of arterial blood gas analysis were recorded after patients entered the operating room(T_(0)),15 min(T_(1))and 30 min(T_(2))after ventilation,and immediately after recovery of spontaneous breathing(T_(3)).The concentration of blood glucose,C‑reactive protein(CRP),cortisol and interleukin‑6(IL‑6)were measured.The number of patients whose operation was suspended due to end‑tidal carbon dioxide partial pressure(P_(ET)CO_(2))>80 mmHg(1 mmHg=0.133 kPa)were recorded.Results There was no hypoxemia in the two groups.Compared with those at T_(0):both groups presented increases in heart beat at T_(2) and T_(3)(P<0.05)and increases in SpO_(2),PaO_(2) and IL‑6 at T_(1) to T_(3)(P<0.05);group H showed increases in MAP,blood glucose and cortisol at T_(2) and T_(3)(P<0.05),increases in CRP at T_(3)(P<0.05),decreases in pH values and increases in PaCO_(2);group S showed increases in MAP,blood glucose and cortisol at T_(3)(P<0.05),and decreases in pH values at T_(2)(P<0.05).Compared with group H:group S presented decreases in heart beat and MPA at T_(2)(P<0.05),increases in pH values and decreases in PaCO_(2) at T_(1) to T_(3)(P<0.05),decreases in blood glucose,cortisol and IL‑6 a
作者
梅菊
汪大彬
王玲凯
黄锦文
李霞
阎文军
Mei Ju;Wang Dabin;Wang Lingkai;Huang Jinwen;Li Xia;Yan Wenjun(The First School of Clinical Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Anesthesiology and Surgery,Gansu Provincial Hospital,Lanzhou 730000,China;School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China)
出处
《国际麻醉学与复苏杂志》
CAS
2021年第12期1240-1244,共5页
International Journal of Anesthesiology and Resuscitation
基金
国家自然科学基金(81560214,81860233)。
关键词
纤维支气管镜检查
麻醉
全身
喉罩
高频‑常频叠加喷射通气
高频喷射通气
Fiberoptic bronchoscopy
Anesthesia,general
Laryngeal mask
Superimposed high frequency jet ventilation
High frequency jet ventilation
