乳房手术中喉罩通气压力与容量控制呼吸模式的比较  

Pressure-versus Volume-controlled Ventilation with Laryngeal Mask Airway in Breast Mastectomy Patients

作　　者：罗文杰[1] 吴磊[1] 端木家启[1] 

机构地区：[1]上海市普陀区人民医院麻醉科,上海200060

出　　处：《中国临床医学》2005年第6期1117-1118,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:比较乳房手术喉罩通气压力控制呼吸(PCV)与容量控制呼吸(VCV)模式对心血管、气道压力与漏气率的影响。方法:30 例全麻下行乳房手术患者,年龄46．05±4．32岁,ASA Ⅰ-Ⅱ级,静脉麻醉诱导后置入喉罩,按随机顺序接受PCV和VCV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)达到30-40mmHg,并稳定15min后分别记录呼吸循环参数。结果:两种通气方式SBP、DBP、HR、PetCO2、SPO2比较无显著差异,P>0．05。PCV时气道峰压和漏气率明显低于VCV,P<0．05,VCV期间有6例气道峰压大于20cmH2O,而PCV期间有3例为20cmH2O,15min后P-V环的密闭性PCV通气方式优于VCV期间。结论:全麻喉罩通气期间PCV较VCV方式能在较低的压力下提供有效的肺通气,是较为理想和安全的通气模式。Objective： Inspiratory pressures and air leak were compared between pressure-controlled ventilation （PCV） and volume-controlled ventilation （VCV） using laryngeal mask airway. Methods： Thirty ASA Ⅰ-Ⅱ patients, aged 46. 05 ± 4. 32 year old. After anesthesia induction and laryngeal mask airway insertion, each patient was randomly assigned to receive pressure-controlled ventilation or volume-controlled ventilation. Tidal volumes and peak pressures were adjusted in order to achieve adequate ventilation （end-tidal carbon dioxide 30-40 mmHg）, the same target of PetCO2 was maintained during the period of ventilation and recorded the parameter of pulmonary and circulation after 15min. Results： Peak airway pressures and percentage of leak were significantly lower in PCV group than those in VCV group （P 〈0. 05. End-tidal carbon dioxide and hemodynamic parameters were similar in both ventilatory models. The pressure of airway of 6 cases were more than 20cmH2O during VSV, while 3 cases was equal to 20cmH2O during PCV, and the airtight of PCV was better than VCV after 15min. Condusion：During general anesthesia in breast cancer patients using laryngeal mask airway,PCV offers lower peak inspiratory airway pressures, while maintaining equal ventilation, than that with VCV.

关 键 词：喉罩 压力控制 容量控制 

分 类 号：R614.2[医药卫生—麻醉学]