丙泊酚靶控麻醉联合经鼻咽高频喷射通气应用于经皮椎体成形术的疗效分析  

Efficacy and safety of target controlled anesthesia with propofol combined with high frequency jet ventilation via nasopharynx in patients undergoing PVP

作　　者：曹晓晟 苏明 赖婷 王晓刚 韦莉萍 冯鹏玖 CAO Xiaosheng;SU Ming;LAI Ting;WANG Xiaogang;WEI Liping;FENG Pengjiu(Department of Anesthesiology,Liuzhou Maternal and Child Health Hospital,Liuzhou 545001,Guangxi,China;Department of Anesthesiology,Liuzhou Traditional Chinese Medicine Hospital,Liuzhou 545001,Guangxi,China)

机构地区：[1]广西柳州市妇幼保健院麻醉科,广西柳州545001 [2]广西柳州市中医医院麻醉科,广西柳州545001

出　　处：《右江医学》2023年第9期789-794,共6页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016055)。

摘　　要：目的观察丙泊酚靶控麻醉联合经鼻咽高频喷射通气对行经皮椎体成形术(percutaneous vertebroplasty,PVP)患者的疗效及安全性。方法选取2019年5月—2021年5月拟行PVP术患者90例,根据随机数字表分成三组,试验组(A组):给予丙泊酚靶控麻醉联合经鼻咽高频喷射通气;对照组:①给予丙泊酚靶控麻醉联合经面罩给氧(B组);②给予丙泊酚靶控麻醉联合经鼻咽通气管给氧(C组)。每组30例。麻醉方法均为丙泊酚靶控输注联合小剂量芬太尼静脉麻醉。比较三组患者不同时间点[进入手术室时(T0)、麻醉诱导前1 min(T1)、麻醉诱导后(T2)、手术开始时(T3)、手术开始后5 min(T4)、手术缝皮刚结束时(T5)、患者清醒时(T6)]SPO 2、MAP、HR值以及术中不良反应发生情况、血气分析结果、舒适满意度及患者对手术医师总满意度。结果①三组患者T0时间点SPO 2、MAP、HR比较差异无统计学意义(P>0.05);B、C组患者T0、T1、T2、T3、T4、T5时间点的SPO 2、MAP、HR比较差异无统计学意义(P>0.05);与T0时间点比较,T1时间点三组患者SPO 2值明显升高,差异有统计学意义(P<0.05);与B、C组患者同一时间点比较,A组患者的T2、T3、T4、T5时间点的SPO 2值显著升高,差异有统计学意义(P<0.05);与T0时间点比较,T2、T3、T4、T5时间点三组患者MAP值均明显下降,差异有统计学意义(P<0.05);三组患者T0、T1、T2、T3、T4、T5时间点的MAP对比,差异无统计学意义(P>0.05);A组患者T1时间点HR值明显高于B、C组(P<0.05);A组患者T3~T6时间点HR值明显低于B、C组,差异有统计学意义(P<0.05)。②A组患者术中不良反应发生率显著低于B、C组,差异有统计学意义(P<0.05)。③麻醉前,三组患者的PO 2、PCO 2比较,差异无统计学意义(P>0.05),与B、C组比较,A组患者手术开始后15 min、术毕的PO 2值明显增高,PCO 2值明显降低,差异均有统计学意义(P<0.05)。④A组患者的舒适满意度明显高于B、C组,差异Objective To observe the efficacy and safety of target controlled anesthesia with propofol combined with high frequency jet ventilation via nasopharynx in patients undergoing percutaneous vertebroplasty(PVP).Methods From May 2019 to May 2021,90 patients who planned to undergo PVP were selected and randomly divided into 3 groups by random number table.Test group(group A):given target controlled anesthesia with propofol combined with nasopharyngeal high frequency jet ventilation;control groups:①given target controlled anesthesia with propofol combined with mask oxygenation(group B);②given target controlled anesthesia with propofol combined with oxygen supply through nasopharyngeal airway(group C),with 30 cases in each group.Anesthesia methods were all target controlled anesthesia with propofol combined with low dose fentanyl intravenous anesthesia.And then,SPO 2,MAP and HR values,adverse reactions during operation,blood gas analysis results,comfort satisfaction,and overall patient satisfaction with surgeon of the three groups at different time points(when patients entered operating room[T0],1 min before the induction of the anesthesia[T1],after induction of anesthesia[T2],at the beginning of the surgery[T3],5 min after the start of surgery[T4],at the end of the surgical skin suture[T5],when patients were awake[T6])were observed and compared.Results①There was no statistically significant difference in SPO 2,MAP and HR among the three groups at T0(P>0.05).There was no statistically significant difference in SPO 2,MAP and HR at T0,T1,T2,T3,T4 and T5 in the group B and group C(P>0.05).Compared with those at T0,the SPO 2 values of the three groups at T1 were significantly higher,and difference was statistically significant(P<0.05).Compared with patients in the group B and the group C at the same time point,the SPO 2 values of patients in the group A at T2,T3,T4 and T5 increased significantly,and difference was statistically significant(P<0.05).Compared with those at T0,MAP values of patients in the three groups at

关 键 词：丙泊酚靶控麻醉 经鼻咽高频喷射通气 经皮椎体成形术 不良反应 满意度 

分 类 号：R614[医药卫生—麻醉学]