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时间:2020-04-02
《丙泊酚静脉麻醉与喉罩通气对支气管黏液运输速度的影响.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、·936·临床麻醉学杂志2OlO年11月第26卷第11期JClinAnesthesi0l,November2010,Vo1.26,No.n·临床研究·丙泊酚静脉麻醉与喉罩通气对支气管黏液运输速度的影响李小葵李天佐【摘要】目的比较丙泊酚或七氟醚麻醉应用喉罩或气管插管机械通气时患者支气管黏液运输速度(BTV)的变化。方法44例全身麻醉下机械通气患者随机均分为四组:喉罩+丙泊酚组(I.P组),气管插管+丙}白酚组(TP组),喉罩+七氟醚组(I.S组);气管插管+七氟醚组(TS组)。麻醉诱导用药相同,麻醉维持分别采
2、用丙泊酚6-7mg·kg·h或七氟醚1.5~2联合雷米芬太尼0.1t0.2/*g·kg·min。机械通气5、60rain时。在纤维支气管镜引导下,用亚甲蓝在右支气管背段黏膜标记,通过测定亚甲蓝的移动速率计算BTV值。结果机械通气5rain后,四组BTV值差异无统计学意义。机械通气60min后,TP、IS、TS组BTV值下降(P<0.01),LP组BTV值差异无统计学意义;组间比较,四组BTV值LP组>TP组>LS组>rs组(p3、最小。【关键词】丙泊酚;七氟醚;喉罩;气管插管;支气管EffectoflaryngealmaskairwayandpropofolanesthesiaonhumanbronchialmUCUStransportvelocityLIXiao-kui,LITian—ZIIO.DepartmentofAnesthesiology,BeijingTongrenHospital,Beijing100730,China[Abstract]ObjectiveTocomparetheeffectofpropofolorse4、vofluranecombinedwithlaryngealmaskairway(LMA)orendotracheaItube(ETT)onbronchia1nlUCUStransportvelocity(BTV)inmechanicalventilatedpatients.MethodsFortyfourpatientsscheduledforelectivesurgerywereequallyrandomizedintooneofthefourgroups:LMA+propofol(groupIP).E5、TT-Ipropofol(groupTP),IMA+sevoflurane(groupIS),,andETT+sevoflurane(groupTS).Anesthesiawasinducedwiththesameanestheticsandwasmaintainedwithpropofol6-7mg·。·horsevoflurane1.5一2%oincombinationwithremifentanil0.1-0.2g·kg‘·rain一,respectively.BTVwascalculatedbyas6、sessingthemovementofmethyleneblueappliedtOthedorsalsurfaceoftherightmainbronchusunderbronchofibroscope5and60minaftermechanicalventilation.ResultsBTVhadnosignificantdifference5rainaftermechanicalventilationamongthefourgroups.Sixtyminaftermechanica1ventilati7、on,HrVdecreasedingroupsTP,ISandTS(P%0.01).andhadnosignificantchangeingroupLP.Forgroupcomparisons,BTVvalueswereasthefollowingsequencegroupIP~>groupTP>groupLS>groupTS(P<0.01).ConclusionPropofolcombinedwithIMAhaslessinhibitioneffecton£rrVinmechanicalventilate8、dpatients[Keywords]Propofol;Sevoflurane;Laryngealmask;除呼吸功能外,呼吸道的防御功能对于患者围证明50>g/ml以上浓度的丙泊酚可加速离体家兔手术麻醉期正常生理功能的维持有重大意义。呼吸气管纤毛的运动频率,其机制可能与呼吸道上皮的道黏液纤毛清除系统(MCC)为呼吸道防御机制的一氧化氮有关L。离体实验与体内实验比较,影响重要组成部分。呼吸道黏液纤毛清除功能障碍可
3、最小。【关键词】丙泊酚;七氟醚;喉罩;气管插管;支气管EffectoflaryngealmaskairwayandpropofolanesthesiaonhumanbronchialmUCUStransportvelocityLIXiao-kui,LITian—ZIIO.DepartmentofAnesthesiology,BeijingTongrenHospital,Beijing100730,China[Abstract]ObjectiveTocomparetheeffectofpropofolorse
4、vofluranecombinedwithlaryngealmaskairway(LMA)orendotracheaItube(ETT)onbronchia1nlUCUStransportvelocity(BTV)inmechanicalventilatedpatients.MethodsFortyfourpatientsscheduledforelectivesurgerywereequallyrandomizedintooneofthefourgroups:LMA+propofol(groupIP).E
5、TT-Ipropofol(groupTP),IMA+sevoflurane(groupIS),,andETT+sevoflurane(groupTS).Anesthesiawasinducedwiththesameanestheticsandwasmaintainedwithpropofol6-7mg·。·horsevoflurane1.5一2%oincombinationwithremifentanil0.1-0.2g·kg‘·rain一,respectively.BTVwascalculatedbyas
6、sessingthemovementofmethyleneblueappliedtOthedorsalsurfaceoftherightmainbronchusunderbronchofibroscope5and60minaftermechanicalventilation.ResultsBTVhadnosignificantdifference5rainaftermechanicalventilationamongthefourgroups.Sixtyminaftermechanica1ventilati
7、on,HrVdecreasedingroupsTP,ISandTS(P%0.01).andhadnosignificantchangeingroupLP.Forgroupcomparisons,BTVvalueswereasthefollowingsequencegroupIP~>groupTP>groupLS>groupTS(P<0.01).ConclusionPropofolcombinedwithIMAhaslessinhibitioneffecton£rrVinmechanicalventilate
8、dpatients[Keywords]Propofol;Sevoflurane;Laryngealmask;除呼吸功能外,呼吸道的防御功能对于患者围证明50>g/ml以上浓度的丙泊酚可加速离体家兔手术麻醉期正常生理功能的维持有重大意义。呼吸气管纤毛的运动频率,其机制可能与呼吸道上皮的道黏液纤毛清除系统(MCC)为呼吸道防御机制的一氧化氮有关L。离体实验与体内实验比较,影响重要组成部分。呼吸道黏液纤毛清除功能障碍可
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