摘要
目的观察持续气道正压通气(CPAP)联合环状软骨压迫法(CP)对全身麻醉诱导期无通气安全时限的影响。方法将40例择期行全麻手术的患者随机分为CPAP+CP组和对照组,每组20例。CPAP+CP组采用CPAP(6 cm-H2O)联合CP法,对照组采用常规诱导插管。在吸氧2 min(T X)及血氧饱和度(SPO2)降至90%(T90)时,采用I-STAT血气分析仪进行血气分析,比较2组入室后(T1)、诱导后(T2)、插管后(T3)及T90时的血压和心率(HR),以及无通气安全时限和胃胀气的发生情况。结果 CPAP+CP组的无通气安全时限显著长于对照组,差异有统计学意义。T X时,CPAP+CP组动脉氧分压(PaO2)显著高于对照组;T90时,2组动脉二氧化碳分压(PaCO2)较T X时明显升高,而PaO2明显降低;CPAP+CP组在T90时PaCO2显著高于对照组,差异有统计学意义。CPAP+CP组未发现1例胃内胀气,优良率高达100%。结论在麻醉诱导前,进行完全密闭面罩的CPAP联合CP可提高氧分压,延长无通气安全时限,防止因人工正压通气造成的胃胀气,且对循环影响小,值得临床推广应用。
Objective To observe the effects of continuous positive airway pressure （CPAP） combined with cricoid pressure （CP） on non- ventilation safe time limit during induction of general anaesthesia. Methods Forty patients who underwent general anaesthesia at the selective term were randomly divided into CPAP ＋ CP group and control group, 20 cases in each group. CPAP （6 cm - H20） combined with CP was applied in CPAP ＋ CP group, while routine sequence intubation in the control group. I - STAT blood gas analyzer was used to analyze blood gas at the time of inhaling oxygen for 2 min （TX） and SpO2 decrease to 90 % （T90）. The blood pressure and heart rate （HR） at the time of going into operation room （T1）, %0, after induction （T2） and intubation （T3）, non - ventilation safe time limit and occurrence of gastric distension were compared in two groups. Re- sults Non - ventilation safe time limit in CPAP ＋ CP group was significantly longer than in the control group, with significant difference. At the time of TX, PaO2 in CPAP ＋ CP group was no- tably higher than in the control group; at the time of T90, PaCO2 in two groups obviously went up compared with TX, while PaO2 evidently went down; PaCO2 in CPAP ＋ CP group was markedly higher than in the control group at the time of Tg0, and the difference showed statistical signifi- cance. There was no one with gastric distension in CPAP ＋ CP group, and the excellent and good rate came up to 100%. Conclusion Before anesthesia induction, CPAP with completely closed facial mask plus CP can increase oxygen partial pressure, prolong non - ventilation safe time limit, prevent the gastric distension due to artificial positive airway pressure and has little impact oncirculation, so it deserves to be popularized and applied in clinical practice.
出处
《实用临床医药杂志》
CAS
2013年第21期73-76,共4页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11321075)
关键词
持续气道正压通气
环状软骨压迫法
诱导期
无通气安全时限
continuous positive airway pressure
cricoid pressure
induction period
non- ventilation safe time limit
