压力控制机械通气应用于小儿气道异物取出术的通气效果

The effects of pressure controlled ventilation for tracheobronchial foreign body removal in children

目的：评价压力控制机械通气在小儿气道异物取出术中的通气效果。方法：拟行气道异物取出术的患儿90例,年龄10个月~3岁,体重8~16kg,ASAⅡ~Ⅲ级。随机分为H组（30例）、P组（30例）和S组（30例）：H组高频喷射通气,P组通过硬支气管镜侧孔行压力控制机械通气,S组保留自主呼吸。记录患儿术前、术毕即刻血气分析,记录术者置镜满意情况、术中缺氧发生率、异物取出情况、手术时间、麻醉苏醒时间和不良事件（屏气、呛咳、支气管或喉痉挛、躁动）的发生情况。结果：术前3组血气结果差异无统计学意义;S组术毕的动脉氧分压明显低于H组和P组（P〈0.05）,CO_2分压则高于H组和P组（P〈0.05）;与S组比较,H组与P组术者置镜满意情况、术中缺氧发生率、异物移除情况、手术时间及麻醉苏醒时间等差异有统计学意义（P〈0.05）,与H组比较,P组手术时间及麻醉苏醒时间、术中缺氧发生率、术毕血气结果差异无统计学意义（P〉0.05）。结论：压力控制机械通气用于小儿异物取出术,与高频喷射通气效果相当,且安全可靠,操作简便。

Objective：To evaluate the effects of pressure controlled ventilation for tracheobronchial foreign body removal in children.Method：Ninety ASA Ⅱ orⅢ children,aged 10 months to 3yr,weighing 8-16 kg undergoing removal of airway foreign body were randomly divided into 3groups（n=30each）：groupⅠ pressure controlled ventilation（P）,group Ⅱ high-frequency jet ventilation（H）,and group Ⅲ,reserve spontaneously breathings.Arterial blood gas analysis of Pre-operation and the end of operation,the occurrence of hypoxia during operation,the duration of operation,anesthesia emergence time and perioperative side effects were recorded.Result：The arterial blood gas analysis（PaO_2,PaCO_2,SaO_2）and SPO_2 of Pre-operation in group P and H had no significant difference.The PaO_2 of the end of operations was significantly higher,and PaCO_2 was lower in group H.The occurrence of hypoxia during operation,the duration of operation,anesthesia emergence time and perioperative side effects in two group had no significant difference.Conclusion：The effects of pressure controlled ventilation and high-frequency jet ventilation for tracheobronchial foreign body removal in children were nearly the same,and pressure controlled ventilation can be commonly used in clinic.