同步间歇指令通气在全麻纤维喉镜声带息肉切除术中的应用  

Application of synchronized intermittent mandatory ventilation in vocal cord polypectomy of general anesthesia fiber laryngoscope

作　　者：郑改芳[1] 张景亮[1] 吕素平[1] 胡振华[1] 刘胜群[1] 赵素贞[1] Zheng Gaifang;Zhang Jingliang;Lv Suping;Hu Zhenhua;Liu Shengqun;Zhao Suzhen(Department of Anesthesiology,Henan Province People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院麻醉科,河南郑州450000

出　　处：《河南医学研究》2018年第3期395-397,共3页Henan Medical Research

基　　金：河南省医学科技攻关项目(201602252)

摘　　要：目的观察同步间歇指令通气模式在全麻纤维喉镜下声带息肉切除术中的应用效果。方法选择60例拟行全麻纤维喉镜下声带息肉切除术患者,按随机数表法分为S组和C组,每组30例。给予S组同步间歇指令通气模式(SIMV),给予C组间歇正压通气模式(IPPV),两组麻醉诱导及维持方法相同。记录两组患者入室时(T_0)、麻醉诱导后(T_1)、置入喉罩后即刻(T_2)、手术开始时(T_3)、手术结束时(T_4)、拔除喉罩时(T5)的血压(MAP)、心率(HR)、脉氧饱和度(SpO_2)、呼吸末二氧化碳(P_(ET)CO_2)、NT指数、气道峰压(Ppeak)、分钟通气量(MV),同时记录患者有无呛咳、苏醒时间及麻醉后监测治疗室(PACU)停留时间。结果 T5时,S组Ppeak、P_(ET)CO_2水平均低于C组,MV高于C组,患者苏醒时间及PACU停留时间均短于C组,差异有统计学意义(P均<0.05)。结论 SIMV通气模式应用于全麻纤维喉镜下声带肿物切除术中,能降低患者苏醒期气道压,提高分钟通气量,缩短苏醒时间及PACU停留时间,值得推广应用。Objective To observe the application effect of synchronized intermittent mandatory ventilation mode in vocal cord polyp excision under general anesthesia fiber laryngoscope.Methods Sixty patients scheduled for vocal cord polyp surgery under general anesthesia were divided into group S and group C according to the random number table,with thirty cases in each group.Patients in group S received intermittent mandatory inspiratory ventilation and were given intermittent positive pressure ventilation in group C.The induction and maintenance of anesthesia were the same in both groups.Records in the two groups,when the patient home(T 0),after anesthesia induction(T 1),placing a laryngeal mask(T 2),immediately after surgery(T 3)at the beginning,at the end of surgery(T 4),removing laryngeal mask(T 5)blood pressure,heart rate,pulse oxygen saturation,respiratory carbon dioxide,NT index,at the end of the airway peak pressure,minute ventilation,and records of patients with and without choking cough,awakening time and the time of being in postanesthesia care unit.Results At T 5,the levels of Ppeak and P ET CO 2 in group S were lower than those in group C,and the MV was higher in group C than those in group C,the awakening time and the time of being in postanesthesia care unit were shorter in group S than in group C,the difference was statistically significant(P<0.05).Conclusion The application of synchronous intermittent mandatory ventilation in vocal cord resection under general anesthesia fiber laryngoscope can reduce airway pressure,improve minute ventilation,shorten awakening time and the time of being in postanesthesia care unit in patients,which is worth popularizing and applying.

关 键 词：同步间歇指令通气 纤维喉镜 全身麻醉 声带息肉切除术 

分 类 号：R615[医药卫生—外科学]