中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
13期
1971-1973
,共3页
高频双向喷射通气%血气分析%血流动力学%气管隆突重建术
高頻雙嚮噴射通氣%血氣分析%血流動力學%氣管隆突重建術
고빈쌍향분사통기%혈기분석%혈류동역학%기관륭돌중건술
High frequency two -way jet ventilation%Blood gas analysis%Hemodynamics%Trachea and Cari-nal reconstruction
目的：探讨高频双向喷射通气对气管隆突重建术患者呼吸循环的影响。方法15例择期肺癌需行气管隆突重建术患者，麻醉诱导插入双腔气管导管且静脉复合麻醉，气管隆突重建时行健侧主支气管高频双向喷射通气，连接一根 Hunsaker 喷射通气导管插入健侧主支气管内3 cm，呼吸频率（RR）120次／min，吸呼比（IE）11，驱动压力0．2～0．25 MPa。且在麻醉前、开胸单肺通气后15 min、高频通气10、20、30 min 及再次单肺通气15 min 时行动脉血气分析，同时监测 MAP、HR、SpO2、PetCO2。结果高频通气时 PaO2较术前的（78．0±10．5）mmHg 显著升高，分别为（161．4±10．2）mmHg、（156．0±15．7）mmHg、（153．0±15．1）mmHg （均 P ＜0．01）；高频通气30 min 时 PaO2较单肺（前）的（165．50±11．3）mmHg 通气降低为（153±15．1）mmHg （P ＜0．05），均高于100 mmHg；PaCO2在高频通气30 min 内较单肺通气（前）时稍增高，差异无统计学意义（P ＞0．05）。结论胸外科气管隆突成型重建术用高频双向喷射通气行健侧肺通气是安全可行的方法。
目的：探討高頻雙嚮噴射通氣對氣管隆突重建術患者呼吸循環的影響。方法15例擇期肺癌需行氣管隆突重建術患者，痳醉誘導插入雙腔氣管導管且靜脈複閤痳醉，氣管隆突重建時行健側主支氣管高頻雙嚮噴射通氣，連接一根 Hunsaker 噴射通氣導管插入健側主支氣管內3 cm，呼吸頻率（RR）120次／min，吸呼比（IE）11，驅動壓力0．2～0．25 MPa。且在痳醉前、開胸單肺通氣後15 min、高頻通氣10、20、30 min 及再次單肺通氣15 min 時行動脈血氣分析，同時鑑測 MAP、HR、SpO2、PetCO2。結果高頻通氣時 PaO2較術前的（78．0±10．5）mmHg 顯著升高，分彆為（161．4±10．2）mmHg、（156．0±15．7）mmHg、（153．0±15．1）mmHg （均 P ＜0．01）；高頻通氣30 min 時 PaO2較單肺（前）的（165．50±11．3）mmHg 通氣降低為（153±15．1）mmHg （P ＜0．05），均高于100 mmHg；PaCO2在高頻通氣30 min 內較單肺通氣（前）時稍增高，差異無統計學意義（P ＞0．05）。結論胸外科氣管隆突成型重建術用高頻雙嚮噴射通氣行健側肺通氣是安全可行的方法。
목적：탐토고빈쌍향분사통기대기관륭돌중건술환자호흡순배적영향。방법15례택기폐암수행기관륭돌중건술환자，마취유도삽입쌍강기관도관차정맥복합마취，기관륭돌중건시행건측주지기관고빈쌍향분사통기，련접일근 Hunsaker 분사통기도관삽입건측주지기관내3 cm，호흡빈솔（RR）120차／min，흡호비（IE）11，구동압력0．2～0．25 MPa。차재마취전、개흉단폐통기후15 min、고빈통기10、20、30 min 급재차단폐통기15 min 시행동맥혈기분석，동시감측 MAP、HR、SpO2、PetCO2。결과고빈통기시 PaO2교술전적（78．0±10．5）mmHg 현저승고，분별위（161．4±10．2）mmHg、（156．0±15．7）mmHg、（153．0±15．1）mmHg （균 P ＜0．01）；고빈통기30 min 시 PaO2교단폐（전）적（165．50±11．3）mmHg 통기강저위（153±15．1）mmHg （P ＜0．05），균고우100 mmHg；PaCO2재고빈통기30 min 내교단폐통기（전）시초증고，차이무통계학의의（P ＞0．05）。결론흉외과기관륭돌성형중건술용고빈쌍향분사통기행건측폐통기시안전가행적방법。
Objective To study the effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction.Methods Fifty patients with lung cancer,who were scheduled for elective trachea and carinal reconstruction,were intubated with double lumen tube following anesthesia induction and general anesthesia.High frequency ventilation was used on the healthful main bronchus during carinal reconstruction,a Hunsaker tube was inserted 3cm into the healthful main bronchus.HFTJV was applied with the respiratory rate of 120 /min,the ratio of inspiration and expiration E =1:1 and drive pressure of 0.2 -0.25Mpa.Blood gas analysis was made before the anesthesia,15 min following one -lung ventilation,10,20, 30 min following HFTJV and 15min following one -lung ventilation,respectively and monitor MAP,HR,SpO2 , PetCO2 .Results PaO2 in high frequency ventilation increased significantly compared with preoperative (78.0 ± 10.5)mmHg,was respectively (161.4 ±10.2)mmHg,(156.0 ±15.7)mmHg,(153.0 ±15.1)mmHg (P <0.01);PaO2 in high frequency ventilation 30min was (153.0 ±15.1)mmHg (P <0.05).It was lower than single lung venti-lation (front 165.50 ±11.3mmHg)and higher than 100mmHg equally;PaCO2 in the high frequency ventilation was slightly increased compared with OLV 30min (front),and the difference was not statistically significant (P >0.05). Conclusion HFTJV is safe and reliable for Trachea and carinal reconstruction.
