经鼻细管高频喷射通气行声带息肉摘除术中的应用研究  

The exploratory development of the extirpation of the polypus of vocal cords via tubule through nose by high-frequency jet ventilation

作　　者：熊理锋[1] 林洁玲[1] 叶佩仪[1] 叶湛青[1] 

机构地区：[1]湛江中心人民医院麻醉科,广东湛江524037

出　　处：《国际医药卫生导报》2008年第17期59-62,共4页International Medicine and Health Guidance News

摘　　要：目的探讨经鼻细管高频喷射通气行声带息肉摘除术静脉麻醉的优越性。方法40例声带息肉患者，随机分为高频喷射通气组（H组）20例，环甲膜穿刺注入气管内2％利多卡因2ml，麻醉诱导后经鼻插入细管行高频喷射通气；常规通气组（C组）20例，麻醉诱导后经口插入小口径气管导管常规通气。观察插管后5分钟（T1）、手术操作开始5分钟（T2）,手术结束5分钟（T3）时间点与麻醉前（T0）血流动力学变化及血氧变化，记录手术时间、手术结束至清醒时间及拔管时间，并统计麻醉药用量。结果C组T1，T2与T0、T3比较MAP、HR明显升高，之间差异有统计学意义（P〈0．05）。而H组MAP、HR变化不大，之间差异无统计学意义（P〉0．05）。两组各时间点SpO2均大于98％。C组麻醉用药量明显较H组增加（P〈0．05）。两组手术时间相近（P〉0．05），但H组清醒时间及拔管时间较C组缩短（P〈0．05）。结论环甲膜穿刺局麻药物注入后经鼻细管高频喷射通气下静脉麻醉对血流动力学影响小，且减少静脉麻醉药的用量，加快术后清醒及拔管。Objective To investigate the superiority of the intravenous anesthesia of the extirpation of the polypus of vocal cords via tubule through nose by high-frequency jet ventilation. Methods The patients was divided into two groups randomly： H group（highfrequency jet ventilation group）（n=20）,intubated tubule through nose and go with highfrequency jet ventilation after anaesthesia inducement. C group（conventional mechanical ventilation group）（n=20）, intubate little caliber tracheal catheter through mouth after anaesthesia inducement. The observed items included; the changes of haemodynamics and SPO2 of the time points at intubated tube 5 min（T1）, started operative procedure 5 min（T2）, ended operative procedure 5min（T3） compared with ahead of anesthesia（T0）.Record the operation time, the time from the termination of opreration to consciousness and extubation. Statistics the drug consumption of intravenous anesthetic. Results The MAP, HR of T1, T2 were higher obviously than T0, T3 in C group ,the differences had statistical significance（P〈0. 05）,but in H group changed little, the differences didn＇t have statistical significance（P〉0.05）.The SPO2 at all time points in two group exceeded 98%. The drug consumption in C group increased obviously than in H group（P〈0.05）.The operation time of two groups were close（P 〉 0.05）,but the time from the termination of opreration to consciousness and extubation in H group shortened than in C group（P〈0.05）.Conclusion The intravenous anesthesia via tubule through nose by high-frequency jet ventilation with thyrocricoid puncture can not only affect haemodynamics little, but also reduce the consumption of intravenous anesthetic and step up the postoperative consciousness and extubation.

关 键 词：环甲膜穿刺 细管 高频喷射通气 声带息肉摘除术 

分 类 号：R614[医药卫生—麻醉学]