原创便携式简易呼吸囊用于全麻复苏的安全性和有效性研究  

Safety and efficacy of original simple portable breathing bag for resuscitation after general anesthesia

作　　者：吴振威 陆雅萍 黄冰 倪华栋 周煦燕 姚明 周海燕[2] 

机构地区：[1]嘉兴市第一医院麻醉科,浙江嘉兴314000 [2]浙江大学医学院附属邵逸夫医院麻醉科

出　　处：《全科医学临床与教育》2017年第6期618-621,共4页Clinical Education of General Practice

基　　金：浙江省医药卫生一般研究计划(2015KYA216);嘉兴市科技计划项目(2017AY33008);嘉兴市第一医院壹计划项目(2017-YA-34);麻醉浙北区域专病中心(2015-24)

摘　　要：目的探讨原创便携式简易呼吸囊在全麻复苏中的安全性和有效性。方法随机选择全麻手术后带气管导管入复苏室(PACU)患者180例,随机分为观察组和对照组,观察组患者恢复自主呼吸后采用原创便携式简易呼吸囊吸氧,对照组患者恢复自主呼吸后采用呼吸机自主呼吸模式吸氧。每组随机分为三组,分别给予不同的氧流量:L1组2 L/min、L2组4 L/min、L3组6 L/min,各30例。分别记录每组患者入PACU后自主呼吸恢复即刻(T1)和自主呼吸恢复10 min(T2)动脉血气分析中的动脉血氧饱和度(Sa O2)、动脉血二氧化碳分压(Pa CO2)、有创动脉平均压(MAP)、心率(HR)、Riker镇静躁动评分(SAS)和脑电熵指数(状态熵SE和反应熵RE)等指标。结果在L1小组中,观察组患者在T2时相的Pa CO2高于对照组,MAP和HR低于对照组,差异均有统计学意义(t分别=2.15、2.11、4.25,P均<0.05),而Sa O2、SAS、SE和RE与对照组比较,差异均无统计学意义(t分别=1.37、0.49、0.77、0.70,P均>0.05)。在L2小组和L3小组中,观察组患者在T2时相的MAP、HR和SAS均低于对照组,差异均有统计学意义(t分别=2.17、4.32、2.24、2.17、4.75、2.50,P均<0.05),而Sa O2、Pa CO2、SE和RE与对照组比较,差异均无统计学意义(t分别=0.56、0.46、0.71、1.19、0.33、1.06、0.32、1.12,P均>0.05)。结论原创便携式简易呼吸囊可用于患者全麻手术后的复苏期自主呼吸培育,在氧流量≥4 L/min时,对MAP、HR和躁动影响更轻。Objective To investigate safety and efficacy of original simple portable breathing bag for for resuscitation after general anesthesia. Methods Totally 180 patients who had endotracheal tube in after general anesthesia were admitted into the PACU. The patients were randomized into observation group and control group. The observation group was given the original simple portable breathing bag,and the control group was given oxygen ventilator by SPONT mode after the spontaneous breathing recovery. The each group was randomized into group L1,group L2 and group L3 with 30 cases in each that recevied differe oxygen flow rate such as 2 L/min,4 L/min and 6 L/min. The Sa O2,Pa CO2,MAP,HR and sedation-agitation scale（SAS）and entropy index（SE and RE）at the immediate moment of the spontaneous breathing recovery（T1）and the moment of ten minutes after the spontaneous breathing recovery（T2）were recorded. Results For the group L1,Pa CO2 at T2 in the observation group was higher than that of the control group,while the MAP and HR were lower than those of the control group（t=2.15,2.11,4.25,P〈0.05）. The Sa O2,SAS,SE and RE in group L1 had nosignificant differences between the observation group and control group at T（2 t=1.37,0.49,0.77,0.70,P〈0.05）. For the group L2 and group L3,the MAP,HR and SAS in the observation group were significantly higher than those of the control group at T（2 t=2.17,4.23,2.24,2.17,4.75,2.50,P〈0.05）,while there were no statistical differences in Sa O2,Pa CO2,SE and RE betweenthe observation group and control group at T2（t=0.56,0.46,0.71,1.19,0.33,1.06,0.32,1.12,P〈0.05）. Conclusion Original simple portable breathing bag can be used for the patients during anesthesia recovery period,and it has the lighter effects on MAP,HR and SAS when the rate of oxygen flow is equal or greater than 4 L/min.

关 键 词：原创便携式简易呼吸囊 全麻复苏 吸氧流量 

分 类 号：R614.2[医药卫生—麻醉学]