两种面罩通气方式在无牙齿老年患者全麻诱导中通气效果的比较  

Comparisons of the Ventilation Effect of Two Mask-ventilation Methods in Edentulous Patients During Induction of General Anesthesia

作　　者：张宁丽 周银燕[2] 张宁平 宋旻璇 屈启才[4] 思永玉[4] ZHANG Ning-li;ZHOU Yin-yan;ZHANG Ning-ping;SONG Min-xuan;QU Qi-cai;SI Yong-yu(Dept.of Anesthesiology,Yunnan Integrated Traditional Chinese and Western Medicine Hospital,Kunming Yunnan 650224;Dept.of Anesthesiology,The First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Kunming Sanatorium of the People's Liberation Army of China,Kunming Yunnan 650307;Dept.of Anesthesiology,The Second Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]云南省中西医结合医院麻醉科,云南昆明650224 [2]昆明医科大学第一附属医院麻醉科,云南昆明650032 [3]中国人民解放军昆明疗养院,云南昆明650307 [4]昆明医科大学第二附属医院麻醉科,云南昆明650101

出　　处：《昆明医科大学学报》2018年第12期77-80,共4页Journal of Kunming Medical University

基　　金：云南省卫生科技计划基金资助项目(2014NS119)

摘　　要：目的比较单纯经鼻面罩通气与改良经口鼻联合面罩通气应用在无牙齿老年患者全麻诱导中的效果。方法选择择期全麻下行手术的无牙齿老年患者62例,ASAⅠ～Ⅲ级,随机均分为经鼻面罩通气组(A组)和改良经口鼻联合面罩通气组(B组)。麻醉诱导后,设置潮气量为8 m L/kg,呼吸频率12次/min,吸呼比1:1.5,由同一操作者使用面罩行控制通气,记录托下颌前、托下颌后1 min、3 min的平均动脉压(MBP)、心率(HR)、脉搏氧饱和度(Sp O_2)、呼气末二氧化碳分压(PETCO_2)、气道压(Paw),测量托下颌前及托下颌后3 min的血气值以及漏气量、漏气率等指标。结果 2组托下颌后3 min的Pa CO_2均上升,A组低于B组,差异有统计学意义(P<0.05);A组托下颌后3 min的氧合指数高于通气前,A组较B组好(P<0.05)。结论无牙齿老年患者全麻诱导时使用单纯经鼻面罩通气较改良经口鼻联合面罩通气效果好。Objective To compare the ventilation effect between the nasal face mask and the ameliorative oral-nasal mask in edentulous elderly patients during induction of general anesthesia.Methods Sixty two edentulous elderly patients with ASA classⅠ~Ⅲwho underwent general anesthesia were enrolled.The patients were randomly divided into two groups(group A and group B),Group A used nasal mask to ventilation,group B used oral-nasal mask to ventilate after anesthesia induction.Mechanical ventilation were performed with VT 8 mL/kg,RR12bpm,I:E 1:1.5.Mean arterial pressure(MBP),pulse oxygen saturation(SPO2),heart rate(HR),pulse oxygen saturation(SPO2),End-tidal CO2(PETCO2),airway pressure(Paw)were recorded before jaw thrust,1 minute and 3 min after jaw thrust.During the induction of anesthesia,we measured blood gas value before and 3 min after jaw thrust,the quantity and rate of the air leakage.All the operations were done by the same operator.Results PaCO2 increased 3 min after jaw thrust in both groups,but it was lower in group A than in group B(P<0.05).The oxygenation index of group A 3 min after ventilation was more than that of before ventilation,and group A was higher than group B3 min after ventilation(P<0.05).Conclusion Using nasal mask ventilation after induction of general anesthesia in patients without teeth is better than using the ameliorative oral-nasal mask ventilation.

关 键 词：鼻面罩 口鼻面罩 无牙齿 面罩通气 全身麻醉诱导 

分 类 号：R614.2[医药卫生—麻醉学]