高频喷射通气在胸腔镜手术麻醉通气中的应用

The application of high frequency jet ventilation in anesthesia ventilator of video assisted thoracic surgery

目的:研究高频喷射通气在胸腔镜手术麻醉通气中的应用。方法:选取胸腔镜手术患者40例,随机分成高频喷射通气组20例和紧闭式通气组20例,研究两组患者氧合情况和手术麻醉时间。结果:高频喷射通气组PO2、SpO2在正常范围内,PCO2得到有效控制。紧闭式通气组,手术后期,PO2、SpO2下降,PCO2显著升高。两组通气后的PO2、PCO2和SpO2比较,差异有统计学意义[(90.5±13.4)mm Hg、(37.1±4.87)mm Hg、(98.5±0.63)%vs(77.9±12.9)mm Hg、(39.8±4.51)mm Hg、(99.1±0.62)%],P<0.05。且高频喷射通气组单肺通气时间和麻醉时间明显优于紧闭式通气组[(45.1±29.1)min、(120±30.2)min vs(64.5±19.2)min、(97.7±31.1)min],P<0.05。结论:高频喷射通气应用于胸腔镜手术麻醉通气,不仅能够改善手术中麻醉通气不足,低氧现象,而且能够延长手术的麻醉时间,为手术的开展提供更多的便利,值得临床推广。

Objective：To study the application of high frequency jet ventilation（HFJV） in anesthesia ventilator of video assisted thoracic surgery（VATS）.Methods：40 patients with VATS,were randomly divided into HFJV group（20 cases） and closed-circuit ventilation group（20 cases）.Oxygenation and surgical anesthesia time of two groups were investigated.Results：PO2 and SpO2 of HFJV group were changed within normal range,PCO2 was controlled effectively;PO2 and SpO2 of closed type ventilation group was lower than before,PCO2 was significantly higher than before ventilation.PO2,PCO2 and SpO2 of the two groups had significant differences [（90.5±13.4）mm Hg,（37.1±4.87）mm Hg,（98.5±0.63）% vs（77.9±12.9）mm Hg,（39.8±4.51）mm Hg,（99.1±0.62）%],P0.05.Ventilation and anesthesia time of HFJV group was better than closed-circuit ventilation group [（45.1±29.1）min,（120±30.2）min vs（64.5±19.2）min,（97.7±31.1）min],P0.05.Conclusion：HFJV used in anesthesia ventilator of VATS can improve anesthetic of hypoventilation during surgery and hypoxia phenomenon and extend the anesthesia time,provide more facilities to carry out the operation,it is worth of clinical practice.