中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
7期
812-814
,共3页
贫血%麻醉,全身%插管法,气管内%无通气安全时限
貧血%痳醉,全身%插管法,氣管內%無通氣安全時限
빈혈%마취,전신%삽관법,기관내%무통기안전시한
Anemia%Anesthesia,general%Intubafion,intratracheal%Non-hypoxic apnoea
目的 评价慢性贫血因素对女性患者全麻诱导气管插管时无通气安全时限的影响.方法 择期妇科手术患者,年龄20 ～ 40岁,ASA分级Ⅰ或Ⅱ级,Mallampati分级Ⅰ或Ⅱ级,BMI＜ 25kg/m2.根据术前血红蛋白(Hb)分为3组(n=25):Hb＞ 110 g/L组(A组)、Hb 90～110 g/L组(B组)、70g/L＜ Hb＜ 90 g/L组(C组).面罩吸入纯氧8 L/min,3 min后常规全麻诱导,诱导期间不进行辅助通气;气管插管后待SpO2降至90％时行纯氧人工通气.记录患者呼吸停止至SpO2降至90％的时间(无通气安全时限)、观察期内最低SpO2和最高PETCO2;分别于面罩吸氧前即刻、呼吸停止即刻及SpO2降至90％时每组随机选10例患者采集桡动脉血行血气分析.结果 与A组相比,B组和C组无通气安全时限缩短(P＜0.01),最低SpO2差异无统计学意义(P＞0.05),C组最高PET CO2、SpO2降至90％时PaCO2降低(P＜0.01);与B组相比,C组无通气安全时限缩短,SpO2降至90％时PaCO2降低(P＜0.01),最低SpO2和最高PET CO2差异无统计学意义(P＞0.05).结论 轻度、中度慢性贫血可将女性患者全麻诱导气管插管时无通气安全时限分别缩短至约6.0、3.5 min.
目的 評價慢性貧血因素對女性患者全痳誘導氣管插管時無通氣安全時限的影響.方法 擇期婦科手術患者,年齡20 ～ 40歲,ASA分級Ⅰ或Ⅱ級,Mallampati分級Ⅰ或Ⅱ級,BMI＜ 25kg/m2.根據術前血紅蛋白(Hb)分為3組(n=25):Hb＞ 110 g/L組(A組)、Hb 90～110 g/L組(B組)、70g/L＜ Hb＜ 90 g/L組(C組).麵罩吸入純氧8 L/min,3 min後常規全痳誘導,誘導期間不進行輔助通氣;氣管插管後待SpO2降至90％時行純氧人工通氣.記錄患者呼吸停止至SpO2降至90％的時間(無通氣安全時限)、觀察期內最低SpO2和最高PETCO2;分彆于麵罩吸氧前即刻、呼吸停止即刻及SpO2降至90％時每組隨機選10例患者採集橈動脈血行血氣分析.結果 與A組相比,B組和C組無通氣安全時限縮短(P＜0.01),最低SpO2差異無統計學意義(P＞0.05),C組最高PET CO2、SpO2降至90％時PaCO2降低(P＜0.01);與B組相比,C組無通氣安全時限縮短,SpO2降至90％時PaCO2降低(P＜0.01),最低SpO2和最高PET CO2差異無統計學意義(P＞0.05).結論 輕度、中度慢性貧血可將女性患者全痳誘導氣管插管時無通氣安全時限分彆縮短至約6.0、3.5 min.
목적 평개만성빈혈인소대녀성환자전마유도기관삽관시무통기안전시한적영향.방법 택기부과수술환자,년령20 ～ 40세,ASA분급Ⅰ혹Ⅱ급,Mallampati분급Ⅰ혹Ⅱ급,BMI＜ 25kg/m2.근거술전혈홍단백(Hb)분위3조(n=25):Hb＞ 110 g/L조(A조)、Hb 90～110 g/L조(B조)、70g/L＜ Hb＜ 90 g/L조(C조).면조흡입순양8 L/min,3 min후상규전마유도,유도기간불진행보조통기;기관삽관후대SpO2강지90％시행순양인공통기.기록환자호흡정지지SpO2강지90％적시간(무통기안전시한)、관찰기내최저SpO2화최고PETCO2;분별우면조흡양전즉각、호흡정지즉각급SpO2강지90％시매조수궤선10례환자채집뇨동맥혈행혈기분석.결과 여A조상비,B조화C조무통기안전시한축단(P＜0.01),최저SpO2차이무통계학의의(P＞0.05),C조최고PET CO2、SpO2강지90％시PaCO2강저(P＜0.01);여B조상비,C조무통기안전시한축단,SpO2강지90％시PaCO2강저(P＜0.01),최저SpO2화최고PET CO2차이무통계학의의(P＞0.05).결론 경도、중도만성빈혈가장녀성환자전마유도기관삽관시무통기안전시한분별축단지약6.0、3.5 min.
Objective To evaluate the effect of chronic anemia on duration of non-hypoxic apnea during tracheal intubation after induction of general anesthesia in female patients.Methods Seventy-five ASA physical status Ⅰ or Ⅱ patients,aged 20-40 yr,of Mallampati class Ⅰ or Ⅱ,with body mass index ＜ 25 kg/m2,were enrolled in the study.According to the test results of hemoglobin (Hb),the patients were allocated into 3 groups (n =25 each):Hb ＞ 110 g/L group (group A),Hb 90-110 g/L group (group B),and 70 g/L ＜ Hb ＜ 90 g/L group (group C).Each patient inhaled 100％ oxygen through a mask with oxygen flow of 8 L/min and 3 min later anesthesia was induced with general anesthesia.Assisted ventilation was not performed during induction.After tracheal intubation,artificial ventilation was performed with pure oxygen when SpO2 decreased to 90％.The time from beginning of apnea to SpO2 of 90％ (duration of non-hypoxic apnea),and the minimum SpO2 and the maximum PET CO2 during the period of observation were recorded.Immediately before oxygen inhalation via a mask,immediately after beginning of apnea,and at the time for SpO2 decreasing to 90％,arterial blood samples were taken from 10 patients randomly chosen from each group for blood gas analysis.Results Compared with group A,the duration of non-hypoxic apnea was significantly shortened,and no significant change was found in the minimum SpO2 in B and C groups,and the maximum PET CO2 and PaCO2 while SpO2 decreasing to 90％ were decreased in group C.Compared with group B,the duration of non-hypoxic apnea was signifi.cantly shortened,PaCO2 while SpO2 decreasing to 90％ was decreased,and no significant change was found in the minimum SpO2 and the maximum PET CO2 in group C.Conclusion Mild and moderate chronic anemia shortens the duration of non-hypoxic apnoea to about 6.0 and 3.5 min,respectively,during tracheal intubation after induction of general anesthesia in female patients.
