无创双相气道正压通气在腭咽成型术患者气管导管拔除后呼吸支持的临床应用

Non-invasive biphasic positive airway pressure ventilation for post extubation respiratory support in the patients with palatopharyngoplasty

目的:探讨无创双相气道正压(biphasic positive airway pressure,BIPAP)通气对阻塞性睡眠呼吸暂停综合征(obstructivesleep apnea syndrone,OSAS)患者腭咽成形术(palatopharyngoplasty,PPP)气管导管拔除后在麻醉苏醒室(post anaesthetic careunit,PACU)呼吸支持的临床应用价值。方法:对30例OSAS患者PPP气管导管拔除后麻醉苏醒期行BIPAP无创通气,观察其治疗前后呼气末二氧化碳分压(PetCO2)、脉搏血氧饱和度(SpO2)变化和对循环的影响。结果:30例患者均在气管拔管后PACU期间因出现低氧和高碳酸血症进行了BIPAP无创呼吸支持治疗,呼吸支持后30min和1h的SpO2和PetCO2都明显好于呼吸支持前,且对患者循环功能无影响。结论:BIPAP无创通气是OSAS患者PPP术气管导管拔除后PACU期间发生低氧和高碳酸血症有效、可靠的预防和治疗方法。

Objective：To evaluate the effect of non-invasive biphasic positive airway pressure（BIPAP）ventilation on post extubation respiration support the in patients with palatopharyngoplasty（PPP）.Methods：Thirty patients with obstructive sleep apnea syndrome（OSAS）undergoing PPP post extubation in the post anaesthetic care unit（PACU）by non-invasive BIPAP ventilation.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）,pulse blood oxygen saturation（SpO2）and end expiratory carbon dioxide partial pressure（PetCO2）before or after non-invasive BIPAP were recorded.Results：Thirty patients with PPP post extubation wered received non-invasive BIPAP ventilation because of hypoxia and hypercapnia.SpO2 increased and PetCO2 decreased significantly after non-invasive BIPAP ventilation 30 minutes and one hour,compared with before non-invasive BIPAP ventilation,however,SBP,DBP,and HR had no difference before and after the non-invasive BIPAP ventilation.Conclusions：Non-invasive BIPAP ventilation is suitable for post extubation respiratory support in patients with OSAS post PPP because of hypoxia and hypercapnia in the PACU.