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《全身麻醉诱导期正压通气对Ⅰ度肥胖患者氧储备的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·464·ShanghaiMedJ,2014,Vo1.37,No.6●临床麻醉●全身麻醉诱导期正压通气对I度肥胖患者氧储备的影响邵大清祝胜美叶志坚卢照德方韬【摘要】目的观察I度肥胖患者全身麻醉诱导期应用持续气道正压(cPAP)和呼气末正压(PEEP)通气模式对氧储备的影响。方法选择拟在气管插管全身麻醉下行择期腹部手术的I度肥胖患者45例,采用随机数字表法将患者分入纯氧机械通气组、CPAP+纯氧机械通气+PEEP组、体积分数0.6氧气机械通气组,每组15例。纯氧机械通气组患者麻醉诱导前在自主呼吸下通过面罩吸纯氧5
2、min,麻醉诱导后行面罩下普通机械通气3min。CPAP+纯氧机械通气+PEEP组患者通过面罩行CPAP吸氧5min,麻醉诱导后行面罩机械通气加用PEEP(6cmH:O,1cmH。0—0.098kPa)3min。体积分数0.6氧气机械通气组的操作步骤和通气参数与纯氧机械通气组相同,仅将吸人氧体积分数调整为0.6。气管插管后暂不连接通气环路,待脉搏血氧饱和度(sO)降至93%时迅速连接环路通气供氧。记录气管插管后s0降至97、95、93的时间。根据气管插管后即刻的血气分析值计算肺内分流率和氧合指数,记录胃部胀气时
3、的视觉模拟评分。结果CPAP+纯氧机械通气+PEEP组S。02降至97、95、93的时间均显著长于另两组(P值均O.05)。纯氧机械通气组的肺内分流率显著高于另两组(P值均<0.05),氧合指数显著低于另两组(P值均4、胃部胀气,CPAP+纯氧机械通气+PEEP组胃部胀气视觉模拟评分O~2分的患者构成比显著低于另两组(P值均5、aqing,ZHUShengmei,YEZhijian,LUZhaode,FANGTeo.DepartmentofAnesthesiology,F『rSfAfiliatedHospital,CollegeofMedicine,ZhejiangUniversity,Hangzhou310003,Zhejinang,ChinaCorrespondingauthor:ZHUShengmei.E-mail:smzhu20088@163.com[Abstract]ObjectiveToobservetheefectofc6、ontinuouspositiveairwaypressure(CPAP)andpositiveend-expiratorypressure(PEEP)ventilationduringinductionofgeneralanesthesiaonoxygenreserveinIdegreeobesepatients.MethodsForty-fiveIdegreeobesepatientsscheduledforabdominalsurgeryundergeneralanesthesiawererandomiz7、edinto3groupsaccordingtorandomdigitstable(n=15each).IngroupA,patientsinhaled100%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductionofanesthesiaandunderwentmechanicalventilationfor3minafterinductionofanesthesia.IngroupB,patientsinhaled100%oxygenv8、iafacemaskwithCPAPfor5minandthenreceivedventilationwithPEEP(6cmH20,1cmH2O=0.098kPa)for3minafterinductionIngroupC。patientsinhaled60%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductio
4、胃部胀气,CPAP+纯氧机械通气+PEEP组胃部胀气视觉模拟评分O~2分的患者构成比显著低于另两组(P值均5、aqing,ZHUShengmei,YEZhijian,LUZhaode,FANGTeo.DepartmentofAnesthesiology,F『rSfAfiliatedHospital,CollegeofMedicine,ZhejiangUniversity,Hangzhou310003,Zhejinang,ChinaCorrespondingauthor:ZHUShengmei.E-mail:smzhu20088@163.com[Abstract]ObjectiveToobservetheefectofc6、ontinuouspositiveairwaypressure(CPAP)andpositiveend-expiratorypressure(PEEP)ventilationduringinductionofgeneralanesthesiaonoxygenreserveinIdegreeobesepatients.MethodsForty-fiveIdegreeobesepatientsscheduledforabdominalsurgeryundergeneralanesthesiawererandomiz7、edinto3groupsaccordingtorandomdigitstable(n=15each).IngroupA,patientsinhaled100%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductionofanesthesiaandunderwentmechanicalventilationfor3minafterinductionofanesthesia.IngroupB,patientsinhaled100%oxygenv8、iafacemaskwithCPAPfor5minandthenreceivedventilationwithPEEP(6cmH20,1cmH2O=0.098kPa)for3minafterinductionIngroupC。patientsinhaled60%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductio
5、aqing,ZHUShengmei,YEZhijian,LUZhaode,FANGTeo.DepartmentofAnesthesiology,F『rSfAfiliatedHospital,CollegeofMedicine,ZhejiangUniversity,Hangzhou310003,Zhejinang,ChinaCorrespondingauthor:ZHUShengmei.E-mail:smzhu20088@163.com[Abstract]ObjectiveToobservetheefectofc
6、ontinuouspositiveairwaypressure(CPAP)andpositiveend-expiratorypressure(PEEP)ventilationduringinductionofgeneralanesthesiaonoxygenreserveinIdegreeobesepatients.MethodsForty-fiveIdegreeobesepatientsscheduledforabdominalsurgeryundergeneralanesthesiawererandomiz
7、edinto3groupsaccordingtorandomdigitstable(n=15each).IngroupA,patientsinhaled100%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductionofanesthesiaandunderwentmechanicalventilationfor3minafterinductionofanesthesia.IngroupB,patientsinhaled100%oxygenv
8、iafacemaskwithCPAPfor5minandthenreceivedventilationwithPEEP(6cmH20,1cmH2O=0.098kPa)for3minafterinductionIngroupC。patientsinhaled60%oxygenviafacemaskunderspontaneousbreathingfor5minbeforeinductio
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