两种通气方式在支撑喉镜术中通气效果的临床观察  

Assessment of Ventilative Effects of HFJV and IPPV in Suspension Laryngoscopy

作　　者：解同山 高敏英 苗韶华[3] 

机构地区：[1]东明县第二人民医院,山东东明274509 [2]东明县中医院 [3]菏泽市立医院

出　　处：《菏泽医学专科学校学报》2001年第4期13-14,共2页Journal of Heze Medical College

摘　　要：目的　比较细气管导管下 ,HFJV与IPPV在支撑喉镜声带息肉摘除术中的通气效果 ,以根据具体情况选择通气方式。方法　随机选择 4 0例ASAⅠ～Ⅱ级声带息肉病人 ,拟行支撑喉镜术 ,随机分为两组 ,HFJV组和IPPV组 ,每组 2 0例。数据均以X±S表示 ,采用t检验。结果　HFJV组和IPPV组手术时间分别为 10 .2± 1.6分钟、10 .1± 1.4分钟 ,无明显差异 (P >0 .0 5 )。HFJV以 6 0次 /分的频率、15 0kPa压力通气 ,术毕CO2 和PH值有显著升高趋势 (P <0 .0 5 ) ;IPPV以 12次 /分的频率、10ml/kg潮气量通气 ,术毕CO2 也有升高趋势 ,但无明显差异 (P >0 .0 5 )。明显低于HFJV组 (P <0 .0 5 )。两组PaO2 明显升高 (P <0 .0 1) ,但两组无显著差异 (P >0 .0 5 )。结论　无论是HFJV还是IPPV ,都能供氧充足 ,满足机体所需 ,但IPPV更易于CO2 排出。因此对于短时间声带息肉支撑喉镜下摘除术控制通气时 ,HFJV与IPPV均可采用 ,而对于肥胖或胸肺顺应性差的病人 。Objective To compare the effects of the intermittent positive pressure ventilation (IPPV) with the high frequency jet ventilation (HFJV) by thin trecheal tube in patients with polyp of vocal cord undergoing suspension laryngoscopy. Methods Forty patients (ASAⅠ～Ⅱ) with vocal polyp undergoing largngoscopy were randomly divided into two groups: IPPV and HFJV, either group had 20 patients,the effects of two groups were tested through χ 2. Results The operation time was 10.2±1.6 min of the IPPV group, and 10.1±1.4min of the HFJV group,there was no significant difference(P>0.05). The PaCO 2 and PH increased significantly (P<0.05) during HFJV, but PaCO 2 increased slightly(P>0.05) during IPPV, and the extent of the increasing was much less than that of HFJV group(P<0.05).The PaO 2 increased obviously after the two ventilations (P<0.01) and the difference between the two groups was not signifiant (P>0.05).Conclusion The oxygen supply in the two ventilations can meet the needs of organism, and the advantage of CO 2 excretion of the IPPV is more than that of the HFJV. Both of them can serve as breath support during laryngoscopy, IPPV is more suitable for patients accompanied fat and failure of thorax or lung compliance.

关 键 词：声带息肉 支撑喉镜术 外科手术 高频喷射通气 间歇正压通气 

分 类 号：R767.4[医药卫生—耳鼻咽喉科] R767.91[医药卫生—临床医学]