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岭南现代临床外科 ›› 2016, Vol. 16 ›› Issue (06): 714-717.DOI: 10.3969/j.issn.1009-976X.2016.06.020

• 论著与临床研究 • 上一篇    下一篇

改良气管导管延长管用于脊柱手术患儿俯卧位下通气的效果分析

龙家棋 陈建廷 李运繁 莫坚   

  1. 廉江市人民医院
  • 通讯作者: 龙家棋

Effect on improved extension tube for endotracheal tube on the pediatric patients undergoing spinal surgery under prone position

LONG Jiaqi,CHEN Jianting,LI Yunfan,MO Jian   

  • Online:2016-12-20 Published:2016-12-20

摘要: 【摘要】目的探讨改良气管导管延长管用于脊柱手术患儿俯卧位下通气的效果。方法选择接受脊柱手术、在卧位下行全身麻醉的32例患儿为观察对象,年龄4~14岁,ASA分级Ⅰ或Ⅱ级,分为观察组及对照组各16例,观察组采用带钢丝加强型气管导管等材料制作延长管,实施气管导管的延长;对照组使用常规气管导管延长管。观察两组患儿压力控制通气模式下患儿潮气量(VT)、每分钟通气量(MV)、动态肺顺应性(Cdyn)、血氧饱和度(SpO2)和呼气末CO2分压(PETCO2);比较两组的血气分析结果差异以及延长管与呼吸回路连接处脱落的情况差异。结果两组患儿的VT、SpO2、PETCO2、麻醉及手术持续时间均无统计学差异(P>0.05),但观察组的MV及Cdyn显著大于对照组(P=0.028及0.021)。麻醉前与苏醒后两组患儿的pH、PaO2及PaCO2均无组间差异,且自身比较同样无统计学差异(P>0.05)。观察组及对照组分别有1及2例出现滑脱,滑脱例数构成无统计学差异(P=0.551),但观察组滑脱时距离麻醉开始时间显著长于对照组。结论改良气管导管延长管有助于增加卧位脊柱手术患儿的每分钟通气量及动态肺顺应性,且增加延长管与呼吸回路接触的牢固性。

关键词: 气管导管, 血气分析, 全身麻醉, 卧位, 机械通气

Abstract: 【Abstract】 Objective To observe the effect of improved extension tube for endotracheal tube (IETET)on the pediatric patients undergoing spinal surgery under prone position. Methods Thirty-two subjects, aged from 4 to 14 years old and with the ASA of Ⅰ or Ⅱ, were enrolled and assigned to the observation group and control group(n=16 for each). All the children underwent operation under the mode of pressure controlled ventilation, and children in the observation group were given the IETET while the control ones were given the traditional ET. The differences in tidal volume (VT), minute ventilation(MV), dynamic lung compliance(Cdyn), blood oxygen saturation(SpO2), and end-tidal carbon dioxide partial pressure (PETCO2) between the two groups were compared, so were the indexes of blood gas analysis, as well as the slipping percentages. Results There was no statistically difference in VT, SpO2, PETCO2, duration of anesthesia and operation between the two groups(P>0.05), but MV and Cdyn in theobservation group were significantly greater than those in the control one(P=0.028 and 0.021). There were also no statistically differences in pH value, PaO2, and PaCO2 between the two groups before anesthesia and after the awakening (P>0.05). There were one case in observation group and two cases in control group encountering slipping, respectively, but the slipping rates between the two groups were not statistically significant. Meanwhile, the lasting time of solid contact between the ET and ventilator circuits was significantly longer in the observation group when compared with the control one. Conclusion The IETET can help increase MV and Cdyn,and strengthen the fastness between ET and ventilator circuits for the pediatric patients undergoing spinal surgery under prone position.

Key words: Prone position, Blood gas analysis, General anesthesia, Mechanical ventilation, Endotracheal tube

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