“┼”字型半紧闭式高频通气与常频通气效果对比  

Comparative study of the effect between the cross-shaped half-closed type of high frequency jet ventilation and the ventilation of the constant normal breathing machine

作　　者：梁治辉[1] 朱冬敏[1] 王伯钧[1] 卢玲静[1] 夏春波[2] 陈清义[1] 

机构地区：[1]柳州医学高等专科学校第一附属医院麻醉科,广西柳州545002 [2]桂林医学院解剖学教研室,广西桂林541004

出　　处：《华夏医学》2013年第3期451-453,共3页Acta Medicinae Sinica

基　　金：广西医药卫生科学研究基金资助项目(重2010080;Z2010123)

摘　　要：目的:为了预防常频普通呼吸机通气下气道压力可能造成的气压伤和呼吸对抗,通过设计"┼"字型半紧闭式高频喷射通气对比常频普通呼吸机通气在麻醉中(自主呼吸完全消失)的通气效果,探讨低气道压下的高频喷射通气在麻醉中的安全性。方法:健康杂种犬8只,随机分为两组:麻醉后高频组(A组)予"┼"字型半紧闭式高频喷射通气;常频组(B组)予常频机械通气。观察动物自主呼吸完全消失情况下的通气效果并比较。结果:在麻醉后无自主呼吸条件下,两组均可维持正常血氧饱和度,但A组气道压力明显低于B组(P<0.05)。在两种呼吸机通气30min后,血气分析结果表明,两种呼吸机均可促进CO2排出,pH值及PCO2(mmHg)无显著性差异,但A组的PO2(mmHg)更高(P<0.05),说明A组的通气效果更好。结论:半紧闭式高频通气可以达到较低的气道压力,亦可代替常频普通呼吸机,有效地保障麻醉中呼吸管理的安全性。Objective： To discuss the safety of high frequency jet ventilation during anesthesia under lower airway pressure through the eomparision of the ventilation effect between the designing of the cross-shaped half-closed type of high frequency jet ventilation and the ventilation of constant normal breathing machine during anesthesia （complete loss of spontaneous breathing） in oder to prevent the pressure injury and respiration confrontation induced by the airway pressure under the ventila- tion of the constant normal breathing machine. Methods： 8 healthy mongrel dogs were randomly divided into two group. Group A adopted cross-shaped half-closed high frequency jet ventilation after anesthesia, while Group B received the ventilation of constant normal breathing machine. The ventilation effect of the dogs under the complete loss of spontaneous breathing was observed and compared. Results： Under the complete loss of spontaneous breathing after the anesthesia, the nor- mal blood oxygen saturation of both groups could be maintained, but airway pressure of Group A was lower than that of Group B （P^0.05）. After 30 mins of venlitation through the two respira- tors, the blood gas analysis results showed that the two respirators could promote the emission of CO2, and there were no significant differences in PH values and PCO2 （mmHg） between two groups, but the PCO2 （mmHg） in Group was higher （P〈0. 05）, indicating that the venlitation effect of Group A was better. Conclusion. Under cross-shaped half-closed high frequency jet venti- lation, lower airway pressure can be reached, so it can replace the the constant normal breathing machine and can effectively ensure the safety of breathing management in anesthesia.

关 键 词：高频喷射通气 常频机械通气 气道压 血气分析 动物犬 

分 类 号：R614.1[医药卫生—麻醉学]