【摘要】 目的比较经魏氏喷射鼻咽通气道行高频喷射通气、改良喉罩控制通气两种通气方式在支气管热成形术中的效果。方法 28例支气管热成形术患者分成A组(经魏氏喷射鼻咽通气道行高频喷射通气,14例)和B组(经改良喉罩控制通气,14例),记录患者入室后(T0),给药/麻醉诱导后1 min(T1),纤维支气管镜置镜即刻(T2),通气后15 min(T3)、30 min(T4)、45 min(T5),术毕即刻(T6),患者睁眼时(T7)的脉搏氧饱和度、心率及平均动脉压;并于T0、T4、T6时点采集足背动脉血测p H、动脉氧分压和动脉二氧化碳分压值;记录置镜时间、手术时间、患者初醒时间;评估麻醉效果、术者满意度和患者满意度;记录术中不良事件发生的例数。结果 A组患者T4、T6时点动脉二氧化碳分压显著升高(P均<0.05),p H显著降低(P<0.05);B组患者的置镜时间和手术时间显著短于A组(P均<0.05),而苏醒时间显著长于A组(P<0.05);B组的麻醉效果和术者满意度均明显好于A组(P均<0.05);B组不良反应发生例数明显少于A组(P<0.05)。结论改良喉罩控制通气方法更适合应用于支气管热成形手术。更多还原

【Abstract】 Objective To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty. Methods Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A( high-frequency jet ventilation through Wei jet nasal airway) and group B( controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room( T0),1 minute after administration / induction( T1), bronchoscope inserting( T2),15 minutes( T3) /30 minutes( T4) /45 minutes( T5) after ventilation,at the end of the operation( T6),and at the recovery of patients’ consciousness( T7). The p H,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0,T4,and T6. The endoscope indwelling duration,operative time, patients ’ awakening time, adverse events during anesthesia, satisfactions of patients and operators,anesthesic effectiveness were also recorded. Results The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B( P < 0. 05). The p H in group A at T4 and T6 was significantly lower than in group B( P < 0. 05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A( P < 0. 05) while the recovery of consciousness in group B was signi ficantly longer than in group A( P < 0. 05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A( P < 0. 05). The number of adverse events in group B was significantly smaller than in group A( P < 0. 05). Conclusion The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.更多还原