全身麻醉诱导时不同面罩通气模式对扁桃体腺样体切除患儿血流动力学及胃进气的影响研究  

Effects of different mask ventilation modes on hemodynamics and gastric air intake in children with tonsillectomy and adenoid resection during induction of general anesthesia

作　　者：李帆[1] 潘守东[1] Li Fan;Pan Shoudong(Department of Anesthesiology,Children′s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院麻醉科,北京100020

出　　处：《中国医师进修杂志》2024年第12期1108-1111,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析全身麻醉诱导时不同面罩通气模式对扁桃体腺样体切除术患儿血流动力学及胃进气的影响。方法前瞻性选择首都儿科研究所附属儿童医院2020年1月至2022年12月收治的86例扁桃体腺样体切除术患儿,按随机数字表法分为对照组和试验组,每组43例。全身麻醉诱导面罩通气时,对照组采用手动控制通气模式,试验组采用压力控制容量保证通气模式。对比两组患儿面罩通气前(T_(0))、自主呼吸消失后60 s(T_(1))、120 s(T_(2))、180 s(T_(3))、手术结束时(T_(4))的血流动力学、呼吸参数、胃窦区面积和胃进气情况。结果与T_(0)时点相比,两组患儿T_(1)、T_(4)时点心率(HR)和平均动脉压(MAP)均减小,但组间比较差异无统计学意义(P>0.05)。试验组患儿T_(1)、T_(2)、T_(3)时点气道峰压、平均气道压均低于对照组[T_(1):(11.09±2.36)cmH_(2)O(1 cmH 2O=0.098 kPa)比(13.42±2.15)cmH_(2)O、(4.98±1.26)cmH_(2)O比(6.52±1.73)cmH_(2)O;T_(2):(11.32±2.04)cmH_(2)O比(13.16±2.37)cmH_(2)O、(5.11±1.37)cmH_(2)O比(6.20±1.55)cmH_(2)O;T_(3):(11.25±2.17)cmH_(2)O比(13.08±2.29)cmH_(2)O、(4.93±1.29)cmH_(2)O比(6.17±1.48)cmH_(2)O],差异有统计学意义(P<0.05)。试验组患儿面罩通气后胃窦区面积小于对照组,胃进气发生率低于对照组[(2.17±0.63)cm^(2)比(2.51±0.85)cm^(2)、9.30%(4/43)比34.88%(15/43)],差异有统计学意义(P<0.05)。结论患儿全身麻醉下行扁桃体腺样体切除术,麻醉诱导面罩通气时采用压力控制容量保证通气模式能保持较低的呼吸参数、降低胃进气发生率。ObjectiveTo analyze the effects of different mask ventilation modes on hemodynamics and gastric air intake in children with tonsillectomy and adenoid resection under general anesthesia.MethodsEight-six children with tonsillectomy from January 2020 to December 2022 treatment in the Children′s Hospital Affiliated to Capital Institute of Pediatrics were enrolled and they were divided into the control group and the test group by random numbers table,43 cases in each group.When inducing mask ventilation under general anesthesia,the control group used manual control ventilation mode,while the experimental group used pressure control volume assurance ventilation mode.The hemodynamics,respiratory parameters,antral area,and gastric air intake in the two groups at before mask ventilation(T_(0)),60 s(T_(1)),120 s(T_(2)),180 s(T_(3)),and at the end of surgery(T_(4))were compared between the two groups.ResultsCompared with T_(0),the heart rate(HR)and mean arterial pressure(MAP)of the two groups at T_(1)and T_(4)were reduced,but there were no statistical differences between the groups(P>0.05).At T_(1),T_(2),and T_(3),the peak airway pressure and average airway pressure in the experimental group were lower than those in the control group,T_(1):(11.09±2.36)cmH_(2)O(1 cmH_(2)O=0.098 kPa)vs.(13.42±2.15)cmH_(2)O,(4.98±1.26)cmH_(2)O vs.(6.52±1.73)cmH_(2)O;T_(2):(11.32±2.04)cmH_(2)O vs.(13.16±2.37)cmH_(2)O,(5.11±1.37)cmH_(2)O vs.(6.20±1.55)cmH_(2)O;T_(3):(11.25±2.17)cmH_(2)O vs.(13.08±2.29)cmH_(2)O,(4.93±1.29)cmH_(2)O vs.(6.17±1.48)cmH_(2)O,there were statistical differences(P<0.05).After face mask ventilation,the area of the gastric antrum in the test group was smaller than that in the control group,and the incidence of gastric intake was lower than that in the control group:(2.17±0.63)cm^(2)vs.(2.51±0.85)cm^(2),9.30%(4/43)vs.34.88%(15/43),there were statistical differences(P<0.05).ConclusionsTonsillectomy and adenoid resection under general anesthesia in children,the use of pressure control volume to ensure ventilat

关 键 词：面罩 持续气道正压通气 血流动力学 呼吸参数 胃进气 

分 类 号：R726.1[医药卫生—儿科]