支撑喉镜引导下喷射通气在气道介入治疗中的应用

目的观察支撑喉镜引导下喷射通气在气道介入治疗中对患者肺交换功能及呼吸道并发症的影响。方法选择行纤维支气管镜介入治疗患者13例,常规全麻诱导后采用支撑喉镜引导下喷射通气。分别记录麻醉诱导前5 min、放置即时、放置后5 min平均动脉压、心率,术前、术中SpO₂、PO₂、PCO₂,术中SpO₂是否下降,术中及术后相关并发症,术后咽喉部疼痛评分,手术者及麻醉医生满意度评分。结果患者支撑喉镜放置即时MAP、HR较放置前明显升高(P<0.05),放置后5 min MAP、HR明显降低(P<0.05)。支撑喉镜引导通气后10 min,SpO₂、PO₂明显升高(P<0.05),PCO₂与术前比较差异无统计学意义。1例患者上唇损伤,1例撤出喉镜时松动牙齿脱落。结论支撑喉镜引导下喷射通气用于气道介入治疗,氧合良好,手术操作视野开阔,并发症少,安全有效。

The application of jet ventilation with laryngoscope via bronchoscopy in airway interventional therapy

Objective The aim of this study was to observe the effection of jet ventilation with laryngoscope via bronchoscopy in airway interventional therapy on lung exchange function and respiratory complications.Methods Thirteen patients undergoing Interventional therapeutic bronchoscopy were enrolled in this study.Jet ventilation with laryngoscope was used after general anesthesia inducing.Vital signs,including mean arterial blood pressure(MAP)and heart rate(HR)were recorded 5 min before induction,laryngoscope inserting and 5 min after inserting.Meanwhile,SpO₂,PO₂,PCO₂ and complications before and during the operation were recorded.The degree of sore throat after operation and physician,satisfaction of physician and anesthetist was also recorded.Results The MAP and HR at laryngoscope inserting were significantly higher than before(P<0.05).Compared with the MAP and HR at laryngoscope inserting,that value was significantly lower 5 min after inserting(P<0.05).The SpO₂ and PO₂ during the operation were significantly higher than before the operation(P<0.05).Compared with PCO₂ before the operation,PCO₂ during the operation was no statistical significance.During the operation,1 patient developed upper lip injury and 1 patient developed loose incisor loss.Conclusion The application of jet ventilation with laryngoscope via bronchoscopy in airway interventional therapy can provide good oxygenation,open surgery field.This model of ventilation was safe and effective.