不同模式正压面罩通气在腹腔镜胆囊切除术患者麻醉诱导中的比较

目的 比较腹腔镜胆囊切除术患者麻醉诱导中三种不同正压面罩通气模式对胃肠胀气的影响以及通气变量的变化,从而选择良好的通气模式,减少面罩通气的不良影响.方法 选择择期行腹腔镜胆囊切除术患者60例,ASA分级为Ⅰ～Ⅱ级,根据麻醉诱导过程中采用不同通气方式分为3组,每组20例,分别为压力控制模式(PVC)组,容量控制模式(VCV)组,手动控制模式(MCV)组,呼吸及血流动力学参数采用麻醉机及其监护仪监测,胃内气体监测采用建立气腹后腹腔镜直视下由有经验麻醉医师判断是否有胃肠胀气,麻醉诱导及其判断是否胀气者为不同麻醉医生,并采用双盲法.结果 3组血流动力学参数差异无统计学意义,而PVC组气道压力明显低于VCV及MCV组,PVC组发生胃肠胀气百分比明显低于VCV及MCV组.结论 压力控制模式是良好的通气模式.

Comparison of different modes of positive pressure mask ventilation during induction of anaethesia undergoing laparoscopic cholecystectomy

Objective To compare different modes of positive pressure mask ventilation during induction of anaesthesia regarding ventilator variables and gastrointestinal flatulence in laparoscopic cholecystectomy,and to choose a better ventilation pattern and reduce the adverse effect during mask ventilating.Methods Sixty patients scheduled for laparoscopic cholecystectomy,ASA status from I to II,were equally divided into three groups: group pressure-controlled ventilation(PCV),group volume-controlled ventilation(VCV),and group manual-controlled ventilation(MCV).Respiratory and haemodynamic variables were monitored during the induction of anaesthesia.Gastrointestinal flatulence was observed directly with peritoneoscope.The induction of anaesthesia and gastrointestinal flatulence observation were in the charge of different anesthesiologists.Results Haemodynamic variables showed no significant differences among the three groups.Group PCV was associated with lower peak airway pressures compared with group MCV and group VCV.gastrointestinal flatulence detected in group PCV was obviously lower than that of group MCV and group VCV.Conclusion PCV is a good modes of ventilation.