改进型麦氏D型呼吸回路在短小手术静脉麻醉中的应用

Application of modified Mapleson D breathing system in intravenous anesthesia for minor surgical procedures

目的研究自主改进的Mapleson-D型(麦氏D型)呼吸回路在短小手术静脉麻醉中的使用效果。方法选择112例在静脉麻醉下行门诊短小手术患者,ASAⅠ～Ⅱ级,随机分为2组,每组56例。A组术中使用普通面罩吸氧,发生呼吸抑制时换用急救呼吸器进行人工辅助通气;B组使用改进型麦氏D型呼吸回路吸氧,发生呼吸抑制时用该呼吸回路行人工通气。记录两组患者术中呼吸频率(RR)、血氧饱和度(SpO2)、呼气末CO2分压(PETCO2),及呼吸抑制患者的发生时间(T1)、纠正时间(T2)。结果使用改进型麦氏D型呼吸回路患者呼吸抑制的总体发生率低于普通面罩吸氧组,低氧血症的发生率较低,且纠正时间也较短。结论与普通吸氧面罩比较,改进型麦氏D型呼吸回路使用简便,发生呼吸抑制程度较轻且纠正迅速,在短小手术静脉麻醉的呼吸管理中较有使用价值。

Objective To assess the clinical effect of modified Mapleson D breathing system in intravenous anesthesia for minor surgical procedures.Methods A total of 112 patients （ASA Ⅰ-Ⅱ） scheduled for minor outpatient surgery were randomly divided into two groups,with 56 in each group.Patients in Group A inhaled oxygen using common face mask,and were transferred to artificial ventilation by emergency ventilator when respiratory depression occurred; those in Group B were subjected to modified Mapleson D breathing system,and were transferred to artificial ventilation using the present breathing system when respiratory depression occurred.The respiratory rate （RR）,oxygen saturation （SpO2）,Partial end-tidal CO2 pressure （PETCO2）,occurrence （T1） and rectification time （T2） of respiratory depression were all recorded in the two groups.Results The incidence of respiratory depression in Group B was lower than that in Group A; moreover,Group B also had a higher incidence of hyoxemia and shorter rectification time compared with Group A.Conclusion Compared with conventional face mask,our modified Mapleson D breathing system is easy and convenient to use,and it leads to lower incidence and quick rectification of respiratory depression,showing a potential in the airway management of patients undergoing minor intravenous anesthesia.