妇科腹腔镜手术不同通气管道及通气模式的对比研究

目的观察妇科腹腔镜手术全麻气管插管或喉罩通气应用不同的潮气量及通气频率下对气道压的影响。方法将60例择期妇科腹腔镜手术患者，随机分为气管插管（I组）和喉罩通气（L组），手术开始实施人工气腹后每隔10min调整一次呼吸参数，呼吸参数分别为A：VT6mL／kg，f16次／分；B：VT8ml／kg，f12次／min；C：VT10mL／kg，f10次／分；D：VT12mL／kg，f8次／min记录各通气参数下的气道峰压（Pmax），平均气道压（Pmean）、呼末CO2（PETCO2）。结果I组和L组低潮气量和高通气频率均比高潮气量低通气频率的Pmax和Pmean低，在相同通气模式下，喉罩通气比气管插管组Pmax和Pmean均低。结论妇科腹腔镜手术选择喉罩通气应用低潮气量（6mL／kg）高频率（16次／min）的通气模式有助于降低气道压，进行肺保护。

Study of comparison of different ventilation modes during the procedure of gynecological laparoscopic operation

Objective To observe the influence of different ventilation methods on the patients of gynecological laparoscopic operation. Methods 60 patients were divide into the group of tracheal cannula （I） and the group of laryngeal mask （L）. Four ventilation methods were applied （A, VT6ml/kg, f16, B, VT8 ml/kg, f12, C, VT10ml/kg, fl0,D, VT12ml/kg, f8）, and then peak voltage of airway, mean pressure of airway and end-tidal pressure of carbon dioxide were recorded. Using the same ventilation methods the peak voltage of airway and the mean pressure of airway of the group of laryngeal mask are lower than the group of tracheal cannula. Results The peak voltage of airway and the mean pressure of airway applying low tidal volume and high ventilatory frequency are lower than high tidal volume and low ventilatory frequency. Conclusion We conclude that low tidal volume and high ventilatory frequency using laryngeal mask are helpful to lower airway pressure and protect lung.