小口径气管导管高频喷射通气用于支撑喉镜手术的临床观察  

Clinical Observation on the High Frequency Jet Ventilation with the Thin Tracheal Tube During Laryngoscopic Surgery Under Suspension Laryngoscope

作　　者：李准民[1] 彭家宽[1] 李飞[1] 龙跃[1] 

机构地区：[1]解放军第163医院麻醉科,湖南长沙410003

出　　处：《医学临床研究》2007年第2期251-253,共3页Journal of Clinical Research

摘　　要：【目的】观察小口径气管导管高频喷射通气(HFJV)用于支撑喉镜手术的通气效果及对手术视野的影响。【方法】择期行支撑喉镜下声带手术病人36例,ASAⅠ-Ⅱ级,随机分为HFJV组(H组)和间歇正压通气(IPPV)组(I组),每组18例。麻醉诱导后,H组插入内径4.0 mm气管导管,I组插入内径6.0 mm气管导管,分别于麻醉前、通气5、10、15 min采集动脉血作血气分析并观察气管插管对手术视野的影响。【结果】两组术中PaO2均升高(P<0.01);I组术中PaCO2无明显变化(P>0.05),H组PaCO2值降低(P<0.01);手术视野暴露H组较I组满意(P<0.01)。【结论】支撑喉镜手术中,小口径气管导管高频喷射通气既能保证良好的通气效果,又能提供良好的手术视野,是一种较理想的通气方法。[Objective]To observe the effects of the high frequency jet ventilation （HFJV） with the thin tracheal tube during laryngoseopic surgery under suspension laryngoscope . [Methods]Thirty eight ASA Ⅰ - Ⅱ patients undergoing surgery of vocal cord under suspension laryngoscope were randomly divided into two groups ： HFJV group （group H, n = 18） and intermittent positive pressure ventilation （IPPV） group （group Ⅰ. n= 18）. After anesthesia induction, group H were inserted ID4.0mm tracheal tube and group Ⅰ were insert ed ID6.0mm tracheal tube. Before anesthesia and 5, 10, 15 min after ventilation , arterial blood samples were collected respectively for blood gas analysis. The exposure of surgical view was assessed. [Resuhs]PaO2 of both groups increased significantly （ P 〈0.01）. The PaCO2 didn＇t change in group Ⅰ（ P 〉0.05）. The PaCO2 decreased significantly in group H（ P 〈0.01） ,but the values didn＇t exceed the tolerable low limit for PaCO2. The surgical view of group H was better in comparison with group Ⅰ（ P 〈0.01 ）. [Conclusion]During laryngoscopic surgery , HFJV with the thin tracheal tube can not only maintain adequate ventilation, but also provide excellent surgical view. It is an ideal ventilation method for laryngoscopie surgery.

关 键 词：喉疾病/外科学 喉镜检查 外科手术 内窥镜 插管法 气管内 

分 类 号：R767[医药卫生—耳鼻咽喉科]