供氧气管导管在麻醉苏醒室的应用研究

Application of oxygen-supply tracheal tubes in post anesthesia care unit

摘要:

目的 观察全身麻醉患者在其手术后麻醉复苏过程中供氧气管导管改善通气质量的效果。方法选择该院在全身麻醉下行四肢手术的患者90 例，随机平均分为3 组，每组30 例，均使用7.0 号气管导管：普通气管导管组（A 组）、普通气管导管气管内吹气组（B 组）及供氧气管导管组（C 组）。术毕带气管导管送麻醉苏醒室（PACU）。入PACU 后记录基础生命体征。当患者恢复自主呼吸后通过气管导管予以相应的不同供氧方式，在四个成串刺激（TOF）T4/T1 ≥ 0.9 时记录患者各项生命体征，并通过麻醉机观察和记算各项呼吸参数。结果 患者入PACU 时各组间生命体征比较，差异无统计学意义（P >0.05）。在TOF T4/T1 ≥ 0.9 时：3 组比较，患者心率和平均动脉压升高（P <0.05），各项气道参数均增加（P <0.05），A 组和B 组间比较，差异无统计学意义（P >0.05）。3 组间呼吸频率和潮气量比较，差异无统计学意义（P >0.05）。结论 供氧气管导管在全身麻醉患者术后苏醒过程中，能够摆脱普通气管导管需要借助的T 型管等辅助呼吸设备，对患者呼吸道的保护及减少呼吸做功有重要意义。

Abstract:

Objective To observe the effect of oxygen-supply tracheal tubes in improving ventilation quality for patients with total intravenous anesthesia. Methods Ninety patients having the limb surgery under total intravenous anesthesia were randomly divided into three groups (each including 30 cases), all of them used No. 7 tracheal tube:group A with common tracheal tubes, group B with tracheal gas insufflation, and group C with oxygen-supply tracheal tubes. After operation the patients were sent to the Post-anesthesia Care Unit (PACU) with tracheal tubes.In the PACU, basic vital signs were recorded. After the patients restored autonomous respiration, they were supplied oxygen via tracheal tubes in different methods. When TOF T4/T1 ≥ 0.9, vital signs were recorded, and breathing parameters were observed and computed by the anaesthesia machine. Results There were no obvious differences in basic vital signs among the groups when the patients entered the PACU (P > 0.05). When TOF T4/T1 ≥ 0.9, HR and MAP of the groups A and B rose obviously as compared to the group C (P < 0.05), meanwhile, Ppeak, Ppla,Pmean and Raw of the groups A and B greatly increased as compared to the group C (P < 0.05); however, there were no obvious differences between the group A and the group B (P > 0.05). For RR and TV, there were no obvious differences among the three groups (P > 0.05). Conclusions During the the anesthesia recovery process of patients with the total intravenous anesthesia, oxygen-supply tracheal tubes are able to supply oxygen without any auxiliary breathing equipment such as T-tube, which is a necessary support to common tracheal tubes. It is of great clinical significance to protect airway of patients and reduce the work of breathing.