不同吸入氧浓度对气管插管全身麻醉下小儿肺炎患者肺泡动脉氧分压差的影响

Effects of different inhaled oxygen concentrations on Alveolar arterial oxygen partial pressure in children with pneumonia under general anesthesia with tracheal intubation

目的分析气管插管全身麻醉下不同吸入氧浓度对小儿肺炎患者肺泡动脉氧分压差的影响。方法选取我院2014年4月～2016年4月在全身麻醉下行气管插管治疗的小儿肺炎患者83例,随机分为两组,两组患儿均给予吸氧治疗,其中对照组41例给予60%氧浓度,观察组42例给予40%氧浓度,观察比较两组患儿治疗前后的肺泡动脉氧分压差变化情况。结果对照组T0、T1、T2阶段的PaO_2、P(A-a)O_2均高于观察组,差异有统计学意义(P<0.05)。两组患儿T0、T1、T2阶段的PCO_2、SpO_2水平比较,差异无统计学意义(P>0.05)。结论机械通气治疗小儿肺炎时高浓度吸氧的P(A-a)O2水平随之升高,反之降低,且40%浓度吸氧能够有效改善肺部通气和换气功能,维持良好的血氧交换,预防低氧血症,值得推荐临床应用。

Objective To analyze the effects of different inhaled oxygen concentrations on Alveolar arterial oxygen partial pressure(PaO2)in children with pneumonia under general anesthesia.Methods Total83children with pneumonia in our hospital from April2014to April2016were enrolled and randomly divided into2groups.All the cases were treated with oxygen inhalation,41of the control group were given60%oxygen concentration,42cases in the observation group were given40%oxygen concentration.The differences of alveolar arterial oxygen partial pressure were compared before and after treatment in the two groups.Results The PaO2and P(A-a)O2in the T0,T1and T2stages of the control group were higher than those of the observation group(P<0.05for each).However there was no significant difference between the two groups at T0,T1and T2.Conclusion The P(Aa)O2level of mechanical ventilation treatment in infantile pneumonia was increased with high concentration oxygen inhalation,whereas its level was decreased;Oxygen inhalation of40%concentration can effectively improve pulmonary ventilation and ventilation function,maintain good oxygen exchange,and prevent hypoxemia.It is worth recommending clinical application.