允许性高碳酸血症通气策略对日间腺样体切除术患儿气管导管拔除的影响  

Effect of permissive hypercapnia ventilation strategy on tracheal tube removal in children undergoing daytime adenoidectomy

作　　者：韩丁[1] 陈莹 潘守东[1] Han Ding;Chen Ying;Pan Shoudong(Department of Anesthesia,Capital Institute of Pediatrics affiliated Children’s Hospital,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：《中国医刊》2025年第3期297-300,共4页Chinese Journal of Medicine

基　　金：2020京津冀科研基金。

摘　　要：目的探讨允许性高碳酸血症通气策略对日间腺样体切除术患儿气管导管拔除的影响。方法选取2024年9—12月于首都儿科研究所附属儿童医院择期行日间腺样体切除术的76例患儿为研究对象,采用随机数字表法分为对照组和观察组,每组38例。对照组实施常规机械通气策略,观察组实施允许性高碳酸血症通气策略。比较分析两组患儿术中指标(麻醉药用量、脑电双频指数、心率、收缩压、舒张压、气管导管拔除时间、手术室停留时间及气道并发症发生情况)。比较分析两组患儿术后指标(睁眼时间、定向力恢复时间、麻醉恢复室停留时间、疼痛相关行为学评分法评分、补救镇痛情况、苏醒期躁动情况、使用口咽通气装置情况以及恶心、呕吐发生情况)。结果两组患儿的术中麻醉药用量、脑电双频指数、心率、收缩压、舒张压、气道并发症发生率及术后睁眼时间、定向力恢复时间、麻醉恢复室停留时间、疼痛相关行为学评分法评分、补救镇痛比例、苏醒期躁动比例、使用口咽通气装置比例和恶心、呕吐发生率比较差异均无统计学差异(P>0.05)。观察组患儿的气管导管拔除时间、手术室停留时间均短于对照组,差异有统计学意义(P<0.05)。结论允许性高碳酸血症通气策略可以显著缩短日间腺样体切除术患儿的气管导管拔除时间和手术室停留时间。Objective To investigate the effect of permissive hypercapnia ventilation strategy on tracheal tube removal in children undergoing daytime adenoidectomy.Method A total of 76 children who underwent daytime adenoidectomy in Capital Institute of Pediatrics affiliated Children’s Hospital from September to December 2024 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 38 cases in each group.The control group was subjected to conventional mechanical ventilation strategy,and the observation group was subjected to permissive hypercapnia ventilation strategy.Intraoperative indexes(anesthetic dosage,BIS,HR,SBP,DBP,tracheal tube removal time,operating room stay time and airway complications)were compared between the two groups.Postoperative indexes(eye opening time,orientation recovery time,stay time in anesthesia recovery room,FLACC score,relief analgesia,agitation during recovery,use of oropharyngeal ventilation device,nausea and vomiting)were compared between the two groups.Result Intraoperative anesthetic dosage,BIS,HR,SBP,DBP,proportion of airway complications,and postoperative eye opening time,orientation recovery time,stay time in anesthesia recovery room,FLACC score,proportion of relief analgesia,proportion of agitation during recovery,proportion of use of oropharyngeal ventilation device,proportion of nausea and vomiting were no significant differences in the two groups(P>0.05).Tracheal tube removal time and operating room stay time in observation group were shorter than those in control group,with statistical significance(P<0.05).Conclusion Permissive hypercapnia ventilation strategy can significantly reduce tracheal tube removal time and operating room stay time in children undergoing daytime adenoidectomy.

关 键 词：允许性高碳酸血症 气管导管拔除 患儿 腺样体切除术 

分 类 号：R734.2[医药卫生—肿瘤]