【摘要】 目的研究喉显微激光手术麻醉中与气管导管燃爆相关的因素,并探讨安全措施。方法采用离体实验方式,对不同材料气管导管、0.9%氯化钠溶液湿润纱条抗激光能力进行测试;对激光致气道燃爆点进行测试;通过动物实验观察气道燃爆所致兔气道及肺损伤的病理变化;临床观察喷射通气频率与吸入氧浓度的关系。结果气管导管抗激光强度依次为抗激光气管导管、硅胶气管导管、乳胶气管导管、PVC气管导管;三层以上0.9%氯化钠溶液湿润纱条可有效保护激光声带手术中的PVC气管导管;激光输出功率为10W、30W时,单脉冲激光击穿气管导管的氧气燃爆点为68%、50%氧浓度;实验兔气道燃爆后以局部灼伤和肺淤血为主;喷射通气频率与吸入氧浓度成反比。结论在喉显微激光声带手术中,PVC气管导管在多层0.9%氯化钠溶液湿润纱条的保护下,采用高频喷射通气技术,控制吸入氧浓度进行肺通气,能有效保障气道的安全。更多还原

【Abstract】 Objective To investigate the safety issues of respiratory tract under anesthesia during throat microlaser surgery. Methods The study was carried out in vitro, the tracheal drive pipes made of different material and the anti-laser ability of 0.9% NaCl- moist gauze strip were tested. Results The anti- laser capability of tracheal drive pipe made of different material was in following order?押 the silica gel tracheal drive pipe, the emulsion tracheal drive pipe, the PVC trachea drive pipe. 0.9% NaCl-moist gauze strip effectively protected lung tissue in the laser vocal cord surgery. When the laser output was 10w and 30w, the single pulse laser penetrates the trachea drive pipe and the oxygen concentration to burn the detonation point was 68% and 50%. Conclusion In the throat micro laser vocal cord surgery, using PVC trachea drive pipe with the multilayer 0.9% Nacl-moist gauze strip protection, and high frequency sprays ventilation and well controlled oxygen concentration may be the safety measures for the patients.更多还原