小儿喉罩通气时压力控制通气和容量控制通气的比较  

Pressure-versus volume-controlled ventilation with laryngeal mask airway in pediatric patients

作　　者：陈锡明[1] 周泓[1] 白洁[1] 

机构地区：[1]上海第二医科大学附属新华医院麻醉科,200092

出　　处：《临床麻醉学杂志》2005年第3期154-155,共2页Journal of Clinical Anesthesiology

摘　　要：目的　比较小儿喉罩通气时压力控制通气(PCV)和容量控制通气(VCV)对气道压力 和喉罩漏气的影响。方法　34例全麻下择期手术的小儿,年龄3～12岁,ASAⅠ～Ⅱ级。静脉麻醉 诱导后置入喉罩。患儿按随机顺序接受VCV和PCV两种通气方式,通气期间保持相同的呼气末二 氧化碳分压(PETCO2)。结果　PCV时气道峰压和漏气率明显低于VCV(P<0.01)。PCV时2例患 儿气道峰压>20cmH2O,而VCV时有9例患儿气道峰压>20cmH2O(P<0.05)。PETCO2和循环 参数无显著性差异。结论　小儿全麻喉罩通气期间,PCV能在较低的气道压力下提供有效的肺通气 效果。Objective Inspiratory pressures and air leak were compared between volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) using laryngeal mask airway (LMA). Methods Thirty-four ASA I-Ⅱ patients, aged 3-12 years, scheduled for elective procedures under general anesthesia, were enrolled. After anesthesia induction and LMA insertion, each patient was randomly assigned to receive VCV or PCV. Tidal volumes andpeak pressures were adjusted in order to achieve adequate ventilation (endtidal carbon dioxide 30-40 mmHg).Results Peak airway pressures and percentage of leak were significantly lower with PCV than those with VCV (P<0.05). Two patients ventilatedwith PCV required peak pressure higher than 20 cmH 2O compared with nine patients ventilated with VCV (P<0.05). Endtidal carbon dioxide and hemodynamic parameterswere similar in both ventilatory models. Conclusions During general anesthesiain children using LMA, PCV offers lower peak inspiratory airway pressures,while maintaining equal ventilation,than that with VCV.

关 键 词：喉罩通气 压力控制通气 容量控制通气 比较 儿童 

分 类 号：R726.1[医药卫生—儿科]