支撑喉镜术中使用常频常压喷射通气的研究

Clinical research on the normal pressure and frequency jet ventilation during suspension laryngoscopy

目的：比较常频常压喷射通气和高频喷射通气在支撑喉镜术中的通气效果。方法：选择３２例ＡＳＡⅠ～Ⅱ级声带息肉患者，拟行支撑喉镜术，随机均分为两组，每组１６例：高频组和常频组。结果：采用６０次／分的频率、１６０ｋＰａ压力进行通气，术中ＰａＣＯ２明显升高（Ｐ＜０．０１）并形成高碳酸血症；采用２２次／分的频率、１６０ｋＰａ的压力进行通气，术中ＰａＣＯ２仅有升高趋势但无显著性差异（Ｐ＞０．０５），且其水平明显低于高频组（Ｐ＜０．０１））。两组患者术中的ＰａＯ２均明显升高且两组间无差异（Ｐ＞０．０５）。结论：无论是常频还是高频喷射通气都能满足机体对供氧的需要，而常频通气比高频通气更有利于二氧化碳排出，由此认为支撑喉镜术中宜采用常频常压喷射通气。

Objective:To compare the effects of the normal pressure,normal frequency jet ventilation with the high frequency jet ventilation Result:The PaCO 2 increased significantly(P<0 01)and hypercapnia occurred during the ventilation with frequency of 60 bpm and driving pressure of 160kPa;but,PaCO 2 increased slightly(P>0 05) during the ventilation with frequency of 22 bpm and driving pressure of 160kPa and the extent of the increasing was much less than that of high frequency group(P<0 01) Conclusion:The normal pressure,normal frequency jet ventilation should serve as breath support during laryngoscopy because of its advantage of CO 2 excretion over high frequency jet ventilation