CAJ | 학술논문

目的比较全身麻醉诱导时低潮气量高频率辅助通气与高潮气量低频率辅助通气对冠心病患者中心静脉压(CVP)的影响,选出对循环血流动力学影响较小的辅助通气方式.方法选择2010年3月-2011年7月于我院行全身麻醉的41例冠心病患者随机分为两组,Ⅰ组在全麻诱导准备插管前低潮气量高频率辅助通气,Ⅱ组在全麻诱导准备插管前高潮气量低频率辅助通气,全程监测心率、血氧饱和度、平均动脉压、中心静脉压,分别记录病人在全麻诱导前、全麻诱导时,气管插管后的CVP值,比较两组患者CVP值的变化.结果全麻诱导前两组的CVP值:Ⅰ组(8.98±2.65)cmH,O；Ⅱ组(8.86±2.91)cmH2O；两组间差异无显著性(P＞0.05).全麻诱导时两组的CVP值:Ⅰ组,(7.45±3.15);Ⅱ组(5.86±3.89) cmH2O;Ⅱ组的CVP值明显低于Ⅰ组(P＜0.05).气管插管后两组的CVP值:Ⅰ组(7.99±2.74) cmH2O;Ⅱ组(6.09±289)cmH2O；Ⅱ组的CVP值明显低于Ⅰ组(P＜0.05).结论全麻诱导时低潮气量高频率辅助通气对CVP的影响小,高潮气量低频率辅助通气对CVP的影响较大.
목적 비교전신마취유도시저조기량고빈솔보조통기여고조기량저빈솔보조통기대관심병환자중심정맥압(CVP)적영향,선출대순배혈류동역학영향교소적보조통기방식.방법 선택2010년3월-2011년7월우아원행전신마취적41례관심병환자수궤분위량조,Ⅰ조재전마유도준비삽관전저조기량고빈솔보조통기,Ⅱ조재전마유도준비삽관전고조기량저빈솔보조통기,전정감측심솔、혈양포화도、평균동맥압、중심정맥압,분별기록병인재전마유도전、전마유도시,기관삽관후적CVP치,비교량조환자CVP치적변화.결과 전마유도전량조적CVP치:Ⅰ조(8.98±2.65)cmH,O；Ⅱ조(8.86±2.91)cmH2O；량조간차이무현저성(P＞0.05).전마유도시량조적CVP치:Ⅰ조,(7.45±3.15);Ⅱ조(5.86±3.89) cmH2O;Ⅱ조적CVP치명현저우Ⅰ조(P＜0.05).기관삽관후량조적CVP치:Ⅰ조(7.99±2.74) cmH2O;Ⅱ조(6.09±289)cmH2O；Ⅱ조적CVP치명현저우Ⅰ조(P＜0.05).결론 전마유도시저조기량고빈솔보조통기대CVP적영향소,고조기량저빈솔보조통기대CVP적영향교대.
Objective To explore the influence of different adjuvant ventilation modes (low tidal volume with high respiratory rate and high tidal volume with low respiratory rate) on central venous pressure (CVP) in patients with coronary heart disease during general anesthesia induction.And to find out an adjuvant ventilation mode which has a less influence on CVP.Methods 41 patients with coronary heart disease practised with general anesthesia in Jiangmen Central Hospital from March 2010 to July 2011 were enrolled for the study.They were randomly divided into two sets.The patients in set Ⅰ were practised the adjuvant ventilation mode of low tidal volume with high respiratory rate during the general anesthesia induction,and the patients in set Ⅱ were practised the adjuvant ventilation mode of high tidal volume with low respiratory rate.All of them were monitored HR,SpO2.MAP,CVP.The CVP of two sets were compared.Results Before general anesthesia,CVP of set Ⅰ was (8.98 ± 2.65) cmH2O,CVP of set Ⅱ was (8.86 ± 2.91) cmH2O.CVP of two sets had no significant difference (P＞ 0.05).During the general anesthesia induction,CVP of set Ⅰ was (7.45 ± 3.15) cmH2O、CVP of set Ⅱ was (5.86 ± 3.89) cmH2O.CVP of set Ⅱ was obviously lower than that of set Ⅰ( P＜ 0.05 ).After tracheal intubatiou,CVP of set Ⅰ was (7.99 ± 2.74) cmH2O,CVP of set Ⅱ was (6.09 ± 2.89) cmH2O.CVP of set Ⅱ was obviously lower than that of set Ⅰ( P＜ 0.05 ).Conclusion By comparing with two ventilation modes,the ventilation mode of high tidal volume with low respiratory rate has a larger influence on CVP.