麻醉诱导期三种面罩通气方式的效果比较  

Comparison of three face-mask ventilation methods during anesthesia induction

作　　者：贺大银 袁东[2] 毛庆祥[3] 

机构地区：[1]解放军驻香港部队医院,广东深圳518048 [2]解放军第三军医大学大坪医院野战外科研究所心内科,重庆400042 [3]解放军第三军医大学大坪医院野战外科研究所麻醉科,重庆400042

出　　处：《临床军医杂志》2011年第4期707-709,共3页Clinical Journal of Medical Officers

摘　　要：目的比较双人面罩手控通气(M)、面罩容量控制通气(VC)、面罩压力控制通气(PC)这三种不同的通气方式在麻醉诱导期的应用效果。方法 90例患者分为三组,M组由两名麻醉医师行双手手控面罩通气,VC组和PC组由一名麻醉医师双手扣面罩,麻醉机给予通气。VC组设定吸气潮气量(VT)8 ml/kg,呼吸频率(RR)16次/min,PC组设定RR 16次/min,调节吸气压力值以达到VT8 ml/kg。持续5min,每分钟记录呼吸、循环等参数。结果M组的呼末CO2<VC组和PC组,而M组的RR、分钟通气量(MV)、气道峰压值、呼气终末正压(PEEP)均明显高于VC组和PC组。其他指标均无统计学差异。结论 三种方式均可以满足患者通气需要,但机控通气(VC和PC)可以降低患者气道峰压和通气频率,是更安全的通气方式。Objective To compare the application effect of two-person manual face-mask ventilation（M）,face-mask volume-controlled（VC） and pressure-controlled（PC） ventilation in the anesthesia induction.Methods Ninety patients were divided into three groups： group M was ventilated by two anesthesiologists using two-handed face-mask ventilation,groups VC and PC were ventilated by one anesthesiologist and anesthesia machine.Volume-controlled ventilation（VC） was performed with a respiratory rate（RR） of 16 breaths/min and a tidal volume（VT） of 8 ml/kg.Pressure-controlled ventilation（PC） was performed with a respiratory rate of 16 breaths/min and the peak airway pressure was set to get a tidal volume of 8 ml/kg.Each mode lasted 5 minutes.The cardiorespiratory variables were recorded over a 1-min period for each ventilation mode.Results ETCO2 of group M was lower than that of groups VC and PC,while RR,minute ventilation（MV）,peak airway pressure,positive end expiratory pressure（PEEP） of group M were significantly higher than that of groups VC and PC.There was no other statistical difference between three groups.Conclusion Although all three methods could provide adequate ventilation,mechanical ventilation in VC and PC resulted in reduced peak airway pressures and respiratory rates when compared with manual face-mask ventilation,thus providing an additional patient safety effect during mask ventilation.

关 键 词：面罩通气 容量控制通气 压力控制通气 麻醉诱导 

分 类 号：R614[医药卫生—麻醉学]