J-Ⅲ型袖珍急救呼吸机在心脏手术后患者转运中的应用

Application of J-Ⅲ mini-ventilator to postoperative transportation for patients undergoing cardiac surgery

目的比较J-Ⅲ型袖珍急救呼吸机和手控呼吸器在体外循环心脏手术后患者转运中的应用效果。方法40例ASAⅢ～Ⅳ级体外循环心脏手术后患者，转运至ICU途中随机分为手控组和机控组，每组20例。手控组在转运途中使用手控呼吸器，机控组在转运途中使用J-Ⅲ型袖珍急救呼吸机，观察两种呼吸支持方式对血流动力学参数及血气分析指标的影响。结果①与术毕比较，手控组ICU时的心率（HR）增快，机控组HR无显著变化；机控组入ICU时的HR、中心静脉压（CVP）低于手控组（P〈0．01）；②两组术毕转运前动脉血氧分压（PaO2）高于转运至ICU时的PaO2，差异有显著性（P〈0．01）；pH、二氧化碳分压（PaCO2）和剩余碱（BE）差异无显著性。术毕和转运至ICU时血气分析指标两组间比较差异无统计学意义。结论J-Ⅲ型袖珍急救呼吸机用于体外循环心脏手术后患者转运途中呼吸支持，简便易行，安全可靠。

AIM To compare the effects of J-m mini-respirator and manual respirator applied to the postoperative transportation of patients undergoing cardiac surgery. METHODS Forty ASA class Ⅲ-Ⅳ patients after surgery for heart diseases were randomly divided into two groups （n = 20 each ） during transportation. In group A, a manual respirator was applied and in group B, a J-Ⅲ mini-ventilator was applied. Hemodynamic parameters, airway pressures and arterial blood gas were measured. RESULTS ① The heart rate in the patients of group A at ICU was significantly increased but no significant changes were observed in the patients of group B compared with that before transportation （ P 〈 0.05 ）. The heart rate and CVP in the patients of group B were lower than those in the patients of group A after trans portation （P 〈0.01 ）. ②PaO2 at the end of operation in both groups was respectively higher than that after transportation （P 〈0.01 ）. But no significant changes were found in pH, PaCO2 and BE. No significant differences were found in pH, PaO2, PaCO2 and BE before transportation and after transportation between the two groups. CONCLUSION J-Ⅲ mini-ventilator is easy to operate and would not significantly affect hemodynamics and arterial blood gas during the postoperative transportation. It can be safely used in the postoperative transportation for patients undergoing cardiac surgery.