高频喷射通气对老年无痛苦纤维支气管镜检 血气结果的影响*

Impact of high-frequency jet ventilation to blood gas of elderly patients undergoing painless fiberoptic bronchoscopy*

摘要:

观察高频喷射通气对老年无痛苦纤维支气管镜检患者血气结果的影响。方法 102例患者随机均分为两组，观察组喷射频率60次/min，对照组喷射频率25次/min。分别在麻醉前及喷射通气10 min时采股动脉血行血气分析，记录呛咳、呼吸抑制、体动反应和二氧化碳CO2蓄积例数。结果 麻醉前及喷射通气10 min后动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）和动脉血氧饱和度（SaO2）组间比较，差异均无统计学意义（P >0.05）。每组喷射通气10 min后，PaO2、PaCO2和SaO2均明显升高，与麻醉前比较，差异有统计学意义（P <0.05）。观察组有4例、对照组有7例发生CO2蓄积，但PaCO2<65 mmHg，组间比较，差异无统计学意义（P >0.05）。结论 高频喷射通气可以为老年患者纤维支气管镜检查麻醉提供可靠的氧供，但不一定能阻止呼吸抑制等因素引起的CO2蓄积，应引起足够的临床重视。

Abstract:

To observe the impact of high-frequency jet ventilation to blood gas of elderly patients undergoing painless fiberoptic bronchoscopy.?Methods?102 patients were randomly divided into observation group and control group. Frequency of 60 jet per minute was used in observation group, and 25 jet in control group. Arteria cruralis blood was sent for blood gas analysis. Bucking, respiratory depress, body dynamic response, carbon dioxide accumulation were recordered.?Results?Between the two groups, the difference of PaO2, PaCO2, SaO2 before aneasthesia and after jet ventilation for 10 minutes was not significant (P > 0.05). In each group, PaO2, PaCO2, SaO2 rised apparently after jet ventilation for 10 minutes (P < 0.05). 4 patients with carbon dioxide accumulation were recordered in observation group and 7 in control group. But PaCO2 < 65 mmHg in every patients, and the difference between the two groups was not significant (P > 0.05).?Conclusion?High-frequency jet ventilation in painless fiberoptic bronchoscopy can provide satisfied oxygen supply, but can not prevent carbon dioxide accumulation on account of respiratory depression. The problem should be pay attention to.