新型辅助简易呼吸器通气装置在喉罩全麻下术后转运中的应用

Application of the novel bag respirator assisted ventilation device in postoperative transport under general anesthesia with laryngeal mask

摘要

目的:探讨一种新型辅助简易呼吸器通气装置在喉罩全麻下术后转运中的应用价值。方法:选择2023年6月至8月重庆医科大学附属第一医院择期行支气管镜检查或治疗的喉罩全麻下术后患者转运133例。随机分为对照组（n=65）和试验组（n=68）,分别在其术后转运行手法简易呼吸器通气和新型辅助简易呼吸器通气装置通气。比较2组患者转运过程中的脉搏氧饱和度（pulse oxygen saturation,SpO₂）、心率（heart rate,HR）、通气频率、转运时间,转运不良事件。结果:2组患者比较,SpO₂的差异有统计学意义(F_组间=18.588,P<0.001),转运中和转运后,试验组患者的SpO₂均明显高于对照组（P<0.001）。2组患者HR比较差异无统计学意义(F_组间=0.089,P=0.766),转运前和转运后,对照组与试验组患者的HR差异有统计学意义(F_时点=12.430,P<0.001),转运前、转运中对照组及试验组患者的HR差异均明显低于转运后（均P<0.001）。试验组的通气频率明显低于人工组（P<0.001）。试验组转运时长高于对照组,但差异无统计学意义（P=0.987）。2组均顺利完成试验,没有发生转运不良事件,达到了安全转运。结论:与手法简易呼吸器通气技术相比,新型辅助简易呼吸器通气装置对喉罩全麻下术后转运患者进行呼吸支持更能够减少对患者血流动力学的影响,利于维持患者生命体征的稳定,预期可作为部分全麻患者院内转运的1种安全有效的通气方法,具有较好的临床应用价值。

Abstract

Objective To explore the application value of a novel bag respirator assisted ventilation device in postoperative transport under general anesthesia with laryngeal mask. Methods A total of 133 patients in postoperative transport who underwent elective bronchoscopy or treatment under general anesthesia with laryngeal mask in the First Affiliated Hospital of Chongqing Medical University， from June to August 2023 were selected. The patients were randomly divided into control group（n=65） and experimental group（n=68），and received manual bag respirator assisted ventilation and the novel bag respirator assisted ventilation device during their postoperative transport，respectively. The pulse oxygen saturation（SpO₂），heart rate（HR），and ventilation frequency during transport，transport duration，and transport-related adverse events were compared between the two groups. Results The difference in SpO₂ was significant when comparing the two groups（F_{between groups}=18.588，P<0.001），and the SpO₂ of patients in the experimental group was significantly higher than that of patients in the control group during and after transport（P<0.001）. The difference in HR was not significant when comparing the two groups（F_{between groups}=0.089，P=0.766），but it was significant between the control and experimental groups before and after transport（F_{time point}=12.430，P<0.001）； the HR in the control and experimental groups before and during transport was significantly lower than that after transport（all P<0.001）. The ventilation frequency of the experimental group was significantly lower than that of the control group（P<0.001）. The transport duration in the experimental group was longer than that in the control group，but the difference was not significant（P=0.987）. Both groups successfully completed the trial without transport-related adverse events and achieved safe transport. Conclusion Compared with the manual bag respirator assisted ventilation technology，the novel bag respirator assisted ventilation device for respiratory support during postoperative transport in patients under general anesthesia with laryngeal mask is more able to reduce the impact on the patient’s hemodynamics and conducive to the maintenance of the patient’s stable vital signs，showing a good clinical application value. It is expected to be a safe and effective ventilation method during intrahospital transport in some patients under general anesthesia.

关键词

简易呼吸器 / 通气 / 恒定潮气量 / 气道管理

Key words

bag respirator / ventilation / constant tidal volume / airway management

基金资助

重庆市科卫联合医学科研项目重点资助项目(2019ZDXM023)