不同吸氧去氮法对全麻诱导期无通气期安全时限影响的比较

Comparison of Three Different Methods of Preoxygenation

目的:探讨不同吸氧去氮方法对全麻诱导期无通气期安全时限的影响。方法:45例气管插管患者随机分为常规吸氧去氮组(3MIN组)、30 s深呼吸4次组(4DB组)与60 s深呼吸8次组(8DB组)。所有患者入手术室后在呼吸空气情况下采集动脉血气标本测定血气分析,并记录SpO2值,吸氧结束时记录SpO2和动脉血的血气分析。记录各例患者SpO2降至97%、95%、93%的时间,在SpO2降至93%时采集动脉血标本测定血气分析。结果:三组SpO2降至97%、95%、93%各时点的时间,3MIN组患者与8DB组相近(P>0.05),而均明显长于4DB组(P<0.05);吸氧后动脉血二氧化碳分压(PaCO2)值三组相近,但在SpO2降至93%时点,3MIN组与8DB组的PaCO2值均明显高于4DB组(P<0.05);吸氧后PaO2值3MIN组与8DB组相近(P>0.05),而均明显高于4DB组(P<0.05)。结论:全麻诱导前的给氧方法中,60 s深呼吸8次法、传统吸氧去氮法的吸氧去氮效果明显优于30 s深呼吸4次法。

Objective：To compare three ways of preoxygenation： 3-min of tidal breathing and eight deep breaths taken within 60 seconds and four deep breaths taken within 30 seconds. Methods ：Forty-five ASA I～Ⅱ patients aged 26～69 years were randomly divided into 3 groups： （1） 3-min group（n=lS）. （2） 8 deep breaths group （8DB）（n=15）. （3）4 deep breaths group （4DB）（n=15）. Arterial blood samples were drawn With a fraction of inspired oxygen of 0. 21（ room air）for arterial blood gas （ABG） analysis. After preoxygenation,SpO2and ABG analysis were monitored again. The time of each patientrs SpO2dropping to 97%, 95%, 93% were recorded. SpO2 and ABG analysis were monitored at SpO2 dropping to 93G. Results ：There were no significant differences between group 3-min and group 8DP comparing the peri od each patient＇ SpO2dropping to 97%,95% and 93%（P〉0.05）,but both longer than that of group 4DB（P〈0.05） . There were no significant differences between group 3-min and group 8DB comparing PaO2 after proxygenati0n （P〉0.05） ,but both higher than that of group 4DB（P〈0.05）. Conclusion ：Comparing three ways of preoxygenation, the 3- min and 8DB method seem to be equally effective,and better than 4DB method.