常频喷射通气中喷针深度对呼吸幅度的影响

Effect of needle depth on respiratory amplitude during normal frequency jet ventilation

目的观察经气管导管进行常频喷射通气时,不同喷针深度对呼吸幅度的影响。方法选择18例气管插管全麻的患者进行自身对照研究,依次进行容量控制通气(volume controlled ventilation,VCV)和喷射通气(jet ventilation,JV),喷针插入导管深度依次为0 cm(JV0)、4 cm(JV4)、8 cm(JV8)。乳头连线上水平放置激光笔,通过测量激光斑点的移动距离比较不同通气条件下的呼吸幅度。结果 VCV、JV0、JV4、JV8四种通气模式下的呼吸幅度分别为(0. 28±0. 09) cm、(0. 51±0. 16) cm、(0. 43±0. 16) cm和(0. 28±0. 11) cm。JV0与JV4相比,呼吸幅度增加,差异有统计学意义(P <0. 01);JV4与JV8相比,呼吸幅度增加,差异有统计学意义(P <0. 01);VCV与JV8相比,呼吸幅度差异无统计学意义,VCV与JV4、JV0相比,呼吸幅度减小,差异均有统计学意义(P <0. 01)。结论常频喷射通气时喷针深度对呼吸幅度有影响,在本试验设定条件下,喷针深度越深呼吸幅度越小。

Objective To observe the effect of needle depth on respiratory amplitude during normal frequency jet ventilation via the endotracheal tube.Methods A self-control study was performed on 18 patients undergoing surgery with tracheal intubation general anesthesia.Volume controlled ventilation(VCV)and jet ventilation were applied to patients in sequence.The depths of needles inserted into the endotracheal tube were 0 cm(JV0),4 cm(JV4)and 8 cm(JV8)respectively.The distances of Laser spot movement were measured in each ventilation mode and respiratory amplitudes were compared between different modes.Results The respiratory amplitudes during VCV,JV0,JV4 and JV8 were 0.28±0.09 cm,0.51±0.16 cm,0.43±0.16 cm and 0.28±0.11 cm respectively.The respiratory amplitude during JV4 was decreased when compared with JV0(P<0.01)but was increased when compared with JV8(P<0.01).The respiratory amplitude during VCV was comparable to JV8 and significantly decreased when compared with JV0 and JV4(P<0.01).Conclusions The needle depth has some effect on respiratory amplitudes during normal frequency jet ventilation.Our study suggests that the respiratory amplitude decreases with needle depth.