供氧气管导管在全身麻醉患者中改善呼吸的应用研究

Application of oxygen supply tracheal intubation in improving respiration in patients under general anesthesia

目的 观察供氧气管导管在全身麻醉患者中保障气道安全的效果。 方法 选择全身麻醉下行大隐静脉激光闭合手术的患者60例，按随机数字表法分为两组（每组30例）：普通气管导管组（C组）和供氧气管导管组（O组）。均用7.0号导管做气管插管。围手术期持续监测两组患者的HR、MAP和SpO2，术中监测气道参数：气道峰压（peak airway pressure, Ppeak）、气道平台压（airway plateau pressure, Ppla）和PETCO2，术毕所有患者均送至PACU。待患者恢复自主呼吸后，监测两组患者PETCO2、需要依赖软皮球供氧的例数及吸痰操作时SpO2下降的例数。 结果 两组患者术前和术中HR、MAP、Ppeak、Ppla和PETCO2比较，差异无统计学意义（P＞0.05），术后C组患者HR、MAP、PETCO2高于O组，差异有统计学意义（P〈0.05）。C组需要依赖软皮球供氧的例数及吸痰操作时SpO2下降的例数均明显高于O组（P＜0.05）。 结论 供氧气管导管能够充分保证患者术中及术后的通气和氧供，并能够使患者在麻醉复苏过程中较少借助于辅助呼吸工具。

Objective To explore the effect of oxygen supply tracheal intubation on ventilation quality in patients under general anesthesia. Methods Sixty patients for great saphenous vein closures with laser under general anesthesia were randomly divided into two groups （each including 30 cases） and respectively received tracheal intubation with either size 7 common tracheal tubes （group C） or oxygen supply tracheal tubes with the same size （group O）. During operation, HR, MAP, SpO2, Ppeak, Ppla and PETCO2 were monitored and recorded. All patients were admitted to anesthesia recovery room after surgery. When patients regained autonomous respiration, the PETCO2, the number of patents relying on continue oxygen supply and the number of patents with reduced SpO2 during aspiration of sputum were recorded. Results There was no significant difference in HR and MAP between two groups in operation room before and during operation （P〉0.05）. Group C and group O did not differ in Ppeak, Ppla and PETCO2 during operation （P〉0.05）. However, there was significant difference in postoperative HR, MAP and PETCO2 between the two groups （P〈0.05）. Additionally, the number of patients in group C depending on continued oxygen supply was significantly higher than that in group O （P〈0.05）. Conclusions Oxygen supply tracheal tubes were able to ensure ventilation and oxygen supply during and after the surgery, and reduce the dependence of patients on auxiliary breathing equipment during anesthesia recovery.