全麻诱导期机械通气不同吸呼比对氧储备的影响  

Effects of Different Breathing Ratios of Mechanical Ventilation on Oxygen Reserve during Induction of General Anesthesia

作　　者：王植 李汝泓[1] 杨雷 WANG Zhi;LI Ruhong;YANG Lei(Department of Anesthesiology,Affiliated Hospital of Chengde Medical College,Chengde,Hebei Province,067000 China)

机构地区：[1]承德医学院附属医院麻醉科,河北承德067000

出　　处：《世界复合医学》2022年第10期98-101,共4页World Journal of Complex Medicine

摘　　要：目的探讨全麻诱导期机械通气压力控制通气模式下不同吸呼比对患者氧储备的影响。方法选取2020年9月—2021年7月于承德医学院附属医院行择期手术患者60例,随机均分为3组,每组20例,A组吸呼比1∶1,B组吸呼比1∶2,C组吸呼比2∶1。观察记录3组患者麻醉诱导前(T_(0)),自主吸入纯氧3 min后(T_(1)),机械通气3 min后(T_(2)),气管插管完成即刻(T_(3))患者体温、机械通气时潮气量和呼末二氧化碳的平均值,采取上述4个时刻动脉血进行血气分析,记录氧分压(PaO_(2))和二氧化碳分压(PaCO_(2))的变化。结果C组患者T2与T1的ΔPaO_(2)为(190.75±25.72)mmHg,明显高于A组和B组,差异有统计学意义(P<0.05);3组T3与T2时刻的ΔPaCO_(2)值差异无统计学意义(P>0.05)。结论在保证肌松效果和气道通畅的前提下,对常规的全麻择期手术患者,诱导期机械通气采取2∶1的吸呼比可改善氧合,增加氧分压,获得较好的氧储备效果。Objective To explore the effect of different breath ratio on oxygen reserve during mechanical ventilation mode during general anesthesia.Methods A total of 60 patients who underwent elective surgery in the Affiliated Hospital of Chengde Medical College from September 2020 to July 2021 were selected and randomly divided into three groups,with 20 cases in each group.The breathing ratio of group A was 1:1,that of group B was 1:2,and that of group C was 2:1.The mean values of body temperature,tidal volume and end-tidal carbon dioxide during mechanical ventilation were observed and recorded before anesthesia induction(T_(0)),3 min after spontaneous inhalation of pure oxygen(T_(1)),3 min after mechanical ventilation(T_(2)),and immediately after tracheal intubation(T_(3)).The arterial blood was taken at the above four times for blood gas analysis,and the changes of partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were recorded.Results The ΔPaO_(2) of T2 and T1 in group C patients was(190.75±25.72)mmHg,which was significantly higher than that in group A and group B,the difference was statistically significant(P<0.05).There was no statistically significant significance in the ΔPaCO_(2) values at T3 and T2 among the three groups(P>0.05).Conclusion On the premise of ensuring the effect of muscle relaxation and airway patency,for patients undergoing elective surgery under general anesthesia,a 2:1 inspiratory ratio of mechanical ventilation during induction can improve oxygenation and increase the partial pressure of oxygen,has a better oxygen storage effect.

关 键 词：全身麻醉 机械通气 吸呼比 氧储备 

分 类 号：R4[医药卫生—临床医学]