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改进型麦氏D型呼吸回路在短小手术静脉麻醉中的应用
刘志强*,陶怡怡,陈秀斌,王诚赟
0
(同济大学附属第一妇婴保健院麻醉科,上海 200040)
摘要:
\[摘要\]目的研究自主改进的Mapleson-D型(麦氏D型)呼吸回路在短小手术静脉麻醉中的使用效果。 方法选择112例在静脉麻醉下行门诊短小手术患者,ASAⅠ~Ⅱ级,随机分为2组,每组56例。A组术中使用普通面罩吸氧,发生呼吸抑制时换用急救呼吸器进行人工辅助通气;B组使用改进型麦氏D型呼吸回路吸氧,发生呼吸抑制时用该呼吸回路行人工通气。记录两组患者术中呼吸频率(RR)、血氧饱和度(SpO2)、呼气末CO2分压 (PETCO2),及呼吸抑制患者的发生时间(T1)、纠正时间(T2)。 结果使用改进型麦氏D型呼吸回路患者呼吸抑制的总体发生率低于普通面罩吸氧组,低氧血症的发生率较低,且纠正时间也较短。结论与普通吸氧面罩比较,改进型麦氏D型呼吸回路使用简便,发生呼吸抑制程度较轻且纠正迅速,在短小手术静脉麻醉的呼吸管理中较有使用价值。
关键词:  静脉麻醉  呼吸抑制  麦氏D型呼吸回路  气道管理
DOI:10.3724/SP.J.1008.2010.01353
投稿时间:2010-11-09修订日期:2010-12-01
基金项目:上海市卫生局基金(2010155).
Application of modified Mapleson D breathing system in intravenous anesthesia for minor surgical procedures
LIU Zhi-qiang*, TAO Yi-yi, CHEN Xiu-bin, WANG Cheng-yun
(Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine,Shanghai 200040, China)
Abstract:
\[Abstract\]ObjectiveTo assess the clinical effect of modified Mapleson D breathing system in intravenous anesthesia for minor surgical procedures. MethodsA total of 112 patients (ASA Ⅰ-Ⅱ) scheduled for minor outpatient surgery were randomly divided into two groups,with 56 in each group. Patients in Group A inhaled oxygen using common face mask, and were transferred to artificial ventilation by emergency ventilator when respiratory depression occurred; those in Group B were subjected to modified Mapleson D breathing system, and were transferred to artificial ventilation using the present breathing system when respiratory depression occurred. The respiratory rate (RR), oxygen saturation (SpO2), Partial end-tidal CO2 pressure (PETCO2), occurrence (T1) and rectification time (T2) of respiratory depression were all recorded in the two groups.ResultsThe incidence of respiratory depression in Group B was lower than that in Group A; moreover, Group B also had a higher incidence of hyoxemia and shorter rectification time compared with Group A. ConclusionCompared with conventional face mask, our modified Mapleson D breathing system is easy and convenient to use, and it leads to lower incidence and quick rectification of respiratory depression, showing a potential in the airway management of patients undergoing minor intravenous anesthesia.
Key words:  intravenous anesthesia  respiratory depression  Mapleson D breathing system  airway management