不同气管内管径对鼾症患儿手术中肺通气功能的影响

Chun Xu, Chengmi Zhang
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After mechanical ventilation under general anesthesia, the following respiratory parameters in the three groups were monitored during surgery: peak airway pressure (Ppeak), plateau airway pressure (Pplat), pulmonary compliance (C), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) ratio (FEV1%). \n \n \nResults \nPpeak, and Pplat in group S were (16.8±2.8) cmH2O (1 cmH2O=0.098 kPa) and (13.6±3.1) cmH2O, respectively, which were significantly higher than those in groups A and L (P<0.05). Ppeak, and Pplat were not significantly changed between groups A and L. FEV1% in group S was (77±5) % which was significantly lower than that in groups A [(80±3)%] and L [(82±5)%] (P<0.05). FEV1% was not significantly changed between groups A and L. 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引用次数: 0

摘要

目的探讨不同气管插管内径对儿童鼾症手术期肺通气功能的影响。方法选择100例计划在全麻下气管插管行腺样体切除术和扁桃体切除术的打鼾儿童,根据随机数表分为三组:小直径组[内径(ID)=(年龄+4+3.5)mm,S组,n=33],适当组[内径=(年龄/4+4.0)mm,a组,n=28],和大直径组[ID=(年龄/4+4.5)mm,L组,n=29]。全麻下机械通气后,在手术期间监测三组的以下呼吸参数:峰值气道压(Ppeak)、平台气道压(Pplat)、肺顺应性(C)、1秒用力呼气量(FEV1)和用力肺活量(FVC)比(FEV1%)。结果S组Ppeak和Pplat分别为(16.8±2.8)cmH2O(1cmH2O=0.098kPa)和(13.6±3.1)cmH2O,显著高于A组和L组(P<0.05)。S组的FEV1%为(77±5)%,明显低于A组[(80±3)%]和L组[(82±5)%](P<0.05)。结论小型气管插管可提高打鼾患儿的Ppeak和Pplat,降低FEV1%,对患儿术中肺通气功能有负面影响。关键词:扁桃体和腺样体切除术;气管插管;气管插管;呼吸功能;儿童
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Effects of different internal diameters of endotracheal tubes on the pulmonary ventilation function of children with snoring disease during surgery
Objective To explore the effects of different internal diameters of endotracheal tubes on the pulmonary ventilation function of children with snoring disease during surgery. Methods One hundred children with snoring disease scheduled for adenoidectomy and tonsillectomy under general anesthesia with tracheal intubation were selected and divided into three groups,according to a random number table: a small diameter group [internal diameter (ID)=(ages/4+3.5) mm, group S, n=33], an appropriate group [ID= (ages/4+4.0) mm, group A, n=28], and a large diameter group [ID=(ages/4+4.5) mm, group L, n=29]. After mechanical ventilation under general anesthesia, the following respiratory parameters in the three groups were monitored during surgery: peak airway pressure (Ppeak), plateau airway pressure (Pplat), pulmonary compliance (C), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) ratio (FEV1%). Results Ppeak, and Pplat in group S were (16.8±2.8) cmH2O (1 cmH2O=0.098 kPa) and (13.6±3.1) cmH2O, respectively, which were significantly higher than those in groups A and L (P<0.05). Ppeak, and Pplat were not significantly changed between groups A and L. FEV1% in group S was (77±5) % which was significantly lower than that in groups A [(80±3)%] and L [(82±5)%] (P<0.05). FEV1% was not significantly changed between groups A and L. Compliance was not significantly different among these groups. Conclusions Small endotracheal tubes can increase Ppeak and Pplat, and reduce FEV1%, with negative effects on pulmonary ventilation function for children with snoring disease during surgery. Key words: Tonsillectomy and adenoidectomy; Endotracheal intubation; Endotracheal tube; Respiratory function; Children
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