全麻期间机械通气对患者心功能的影响  

Effect of mechanical ventilation on cardiac function during general anesthesia

作　　者：蒋海[1] 蒋小朴[2] 林世清[2] 陈锡辉[3] 靳三庆[1] 

机构地区：[1]中山大学附属第一医院黄埔院区麻醉科,广州市510070 [2]中山大学附属第一医院麻醉科 [3]中山大学附属第一医院耳鼻喉科

出　　处：《中华麻醉学杂志》2008年第6期522-525,共4页Chinese Journal of Anesthesiology

基　　金：广东省医学科学研究基金资助项目（A2003170）

摘　　要：目的评价全麻期间机械通气对患者心功能的影响。方法选择鼓室成形术ASAⅠ或Ⅱ级患者53例，随机分为机械通气组（M组，n=28）和自主呼吸组（S组，n=25）。M组麻醉诱导气管插管后行机械通气；S组采取麻醉慢诱导气管插管后保留自主呼吸。术中维持BIS40-60。于气管插管前、气管插管后1、5、10、20、40、60、90、120及150min时记录心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SpO2）、心输出量（CO）及每搏量（SV）；并于气管插管后各时点记录呼气末二氧化碳分压（PETCO2）、潮气量（VT）、呼吸频率（RR）及气道峰压（Ppeak）。结果与S组比较，M组CO、SV、HR及MAP差异无统计学意义（P〉0．05），SpO2、VT及Ppeak较高，RR较慢，PETCO2较低（P〈0．05），但均在正常范围。结论临床麻醉中短时间机械通气对患者的心功能无明显影响。Objective To evaluate the effect of mechanical ventilation on cardiac function during general anesthesia. Methods Fifty-three ASA Ⅰ or Ⅱ patients aged 18-55 yr scheduled for elective tympanic cavity plasty surgery were randomly divided into 2 groups： mechanical ventilation group （group M, n = 28 ） and spontaneous respiration group （group S, n = 25 ）. Mechanical ventilation was applied in group M after rapid induction＇ and tracheal intubation, while in group S spontaneous respiration was maintained after slow induction and tracheal intubation. BIS value was maintaited between 40-60 during anesthesia in both groups. Before induction of anesthesia, the baseline of heart rate （HR）, mean arterial pressure （MAP）, pulse oxygen saturation （SpOt）, cardiac output （CO） and stroke volume （SV） were recorded, The parameters including HR and MAP, SpO2, CO, SV, tidal volume （VT）, respiratory rate （RR）, partial pressure of carbon dioxide in endexpiratory gas （PET CO2 ） and peak inspiratory pressure （Ppeak） were recorded at 1, 5, 10, 20, 40, 60, 90, 120 and 150 min after intubation. Results There were no statistical differences in CO, SV, HR, MAP between the two groups, SpO2 , VT and Ppeak were significantly higher and RR and PETCO2 were significantly lower in group M than in group S, but the values were in the normal range. Conclusion The short-term mechanical ventilation has no adverse effect on cardiac function during general anesthesia in patients with normal heart function.

关 键 词：呼吸 人工 麻醉 全身 心脏功能试验 

分 类 号：R614[医药卫生—麻醉学]