高频喷射通气对无痛纤支镜检查患者血气的影响

目的研究HFJV在肺结核患者无痛纤维支气管镜(FOB)诊治中血气变化。方法 100例FOB介入诊治的肺结核患者随机分为A组和B组。A组50例,以HFJV联合靶控输注麻醉;B组50例,以鼻导管吸氧联合靶控输注麻醉,分别进行吸痰、肺泡灌洗等综合治疗。分别记录T0、T1、T2及T3时的ABG、ECG及Bp、HR和SpO2,计算RPP,观察镜检期间有无呛咳、体动,并在苏醒后询问有无术中知晓发生。结果两组PaO2明显下降,T1时的Bp、RPP低于T0、HR增快(P<0.05),部分出现心律失常,ST-T段压低,A组PaO2较B组明显升高且超过术前水平(P<0.05)。镜检期间患者SpO2维持在麻醉前值,无一例出现呛咳、体动或术中知晓。结论 HFJV对肺结核患者行无痛FOB能提高PaO2,减少并发症,使FOB更安全。

The Affect of High Jet Frequency Ventilation on Painless Fiberobronchoscopy Examination of Patients' Blood-gases

Objective To evaluate the effects of using high frequency jet ventilation during painless bronchoscopy on high-risk pulmonary tuberculosis patients’ for diagnosis and treatment.Methods The 100 tuberculosis patients receiving bronchoscope were randomly divided into HFJV and control groups.The HFJV group of 50 patients was anesthetized by HFJV support joint target-controlled infusion anesthesia;while the control group of 50 patients was anesthetized by nasal cannel oxygen anesthesia combined target-controlled infusion.Some parameters such as arterial blood gas(ABG),electrocardiogram(ECG),blood pressure(Bp),heart rate(HR) and arterial oxygen saturation(SpO2) were measured at the following time points: before anesthesia(T0),surgery(T1),end of surgery(T2) and after the first 10 min(T3).Results Arterial partial pressure of oxygen of the control groups significantly decreased during the operation.The HFJV group was significantly higher than the control group,which was higher than preoperative levels(P<0.05).Conclusion HFJV can improve PaO2,reduces FOB’s complications and make FOB safer.