不同面罩通气模式对全麻下行扁桃体腺样体切除术患儿血流动力学及胃进气的影响研究  

Effect of different mask ventilation modes on hemodynamics and gastric intake in children with tonsil adenoidectomy under general anesthesia

作　　者：冯志东 田苗苗 玄春月 陈云鹤[1] FENG Zhi-dong;TIAN Miao-miao;XUAN Chun-yue(Department of Anesthesiology,Qinhuangdao Port Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市海港医院麻醉科,066000

出　　处：《中国现代药物应用》2024年第21期57-60,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨不同面罩通气模式对全身麻醉(全麻)下行扁桃体腺样体切除术患儿血流动力学、胃进气的影响。方法选取100例全麻下行扁桃体腺样体切除术的患儿为对象,以随机数字表法分组原则将患儿分为A组(33例)、B组(33例)、C组(34例)。A组行手动控制通气,B组行压力控制通气(PCV),C组行压力控制容量保证通气(PCV-VG)。对比三组患儿不同时段[自主呼吸消失即刻(T_(0))、面罩通气60 s(T_(1))、面罩通气120 s(T_(2))、面罩通气180 s(T_(3))]血流动力学指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))],胃进气及术后相关并发症发生率。结果三组患儿在T_(0)~T_(3)时的MAP、HR水平比较,差异均无统计学意义(P>0.05);T_(0)时,三组患儿SpO_(2)水平相当,差异无统计学意义(P>0.05);A组T_(1)~T_(3)时SpO_(2)分别为(96.95±1.24)%、(96.63±1.19)%、(96.57±1.09)%,B组T_(1)~T_(3)时SpO_(2)分别为(97.27±1.21)%、(97.08±1.17)%、(96.91±1.11)%,C组T_(1)~T_(3)时SpO_(2)分别为(98.14±1.17)%、(97.86±1.20)%、(97.78±1.15)%,T_(1)~T_(3)时三组SpO_(2)水平比较差异有统计学意义(P<0.05),C组SpO_(2)水平稍高于A组、B组。A组、B组、C组胃进气发生率分别为30.30%、9.09%、5.88%。B组、C组胃进气发生率低于A组,差异有统计学意义(P<0.05),B组、C组胃进气发生率比较差异无统计学意义(P>0.05);三组术后相关并发症发生率相当,组间两两对比差异均无统计学意义(P>0.05)。结论在全麻下行扁桃体腺样体切除术中,PCV与PCV-VG通气模式对保持较低气道峰压、较少胃进气的效果相当,但PCV-VG更能够使患儿保持更好的潮气量和肺顺应性,维持血流动力学稳定的效果更为理想。Objective To explore the effect of different mask ventilation modes on hemodynamics and gastric intake in children with tonsil adenoidectomy under general anesthesia.Methods A total of 100 cases who underwent tonsil adenoidectomy under general anesthesia were selected and grouped into group A(33 cases),group B(33 cases)and group C(34 cases)on the principle of randomized numerical table method.Group A was given manual controlled ventilation,group B was given pressure controlled ventilation(PCV)and group C was given pressure-controlled ventilation,volume-guaranteed(PCV-VG).Comparison was made on hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SpO_(2))],gastric intake and the incidence of postoperative complications in the three groups at different time intervals[immediate disappearance of spontaneous respiration(T_(0)),60 s of mask ventilation(T_(1)),120 s of mask ventilation(T_(2)),180 s of mask ventilation(T_(3))].Results Comparison of MAP and HR levels of the three groups at T_(0)-T_(3),the differences were not statistically significant(P>0.05).At T_(0),SpO_(2) levels of the three groups of children were comparable,and the difference was not statistically significant(P>0.05).In group A,SpO_(2) at T_(1)-T_(3) were(96.95±1.24)%,(96.63±1.19)%and(96.57±1.09)%,SpO_(2) at T_(1)-T_(3) in group B were(97.27±1.21)%,(97.08±1.17)%,(96.91±1.11)%,SpO_(2) at T_(1)-T_(3) in group C were(98.14±1.17)%,(97.86±1.20)%,(97.78±1.15)%,respectively.The difference in SpO_(2) levels among the three groups at T_(1)-T_(3) was statistically significant(P<0.05),and SpO_(2) levels in group C were slightly higher than those in group A and group B.The incidence rates of gastric intake in group A,group B,and group C were 30.30%,9.09%,and 5.88%,respectively.The incidence of gastric intake in group B and group C was lower than that in group A,and the difference was statistically significant(P<0.05),and the difference in the incidence of gastric intake between group B and group C was not statistically signi

关 键 词：面罩通气 扁桃体腺样体切除术 血流动力学 胃进气 

分 类 号：R726.1[医药卫生—儿科]