文章摘要
声门上喷射通气用于非插管静脉麻醉下宫腔镜手术的效果
Effect of supraglottic jet ventilation for the patients under intravenous anesthesia without intubation during hysteroscopy
  
DOI：10.12089/jca.2019.08.009
中文关键词: 喷射通气  静脉麻醉  超声  胃窦  宫腔镜检查
英文关键词: Jet ventilation  Intravenous anesthesia  Ultrasound  Gastric antrum  Hysteroscopy
基金项目:
作者单位E-mail
梁汉生 100044,北京大学人民医院麻醉科  
李清月 100044,北京大学人民医院麻醉科  
李伟 100044,北京大学人民医院麻醉科  
冯艺 100044,北京大学人民医院麻醉科 yifeng65@sina.com 
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中文摘要:
      
目的 观察声门上喷射通气用于非插管静脉麻醉下宫腔镜手术的安全性和有效性。
方法 择期行非插管静脉麻醉下宫腔镜手术患者120例，年龄18~65岁，ASA Ⅰ或Ⅱ级，MallampattiⅠ或Ⅱ级，随机分为喷射组和对照组，每组60例。麻醉诱导后，对照组面罩吸氧，氧流量6 L/min，FiO2 45%；喷射组经一侧鼻孔置入魏氏经鼻喷射导管进行声门上喷射给氧，并在喷射通气前后行超声测量胃窦部横截面积（CSA-GA）。观察并记录术中SpO2< 95%、托下颌、面罩加压给氧以及鼻出血、呛咳、无意识肢体运动的例数；记录喷射通气前后的CSA-GA。
结果 喷射组SpO2< 95%的发生率明显低于对照组（P<0.05）。喷射组患者CSA-GA在喷射通气前后差异无统计学意义。喷射组托下颌、面罩加压给氧、呛咳、无意识肢体运动的例数明显少于对照组（P<0.05）。
结论 声门上喷射通气有效地维持氧合，不增加反流误吸风险，提高了非插管静脉麻醉下宫腔镜手术的安全性。
英文摘要:
      
Objective To observe the safety and efficacy of supraglottic jet ventilation (SJV) for the patients under intravenous anesthesia without intubation during hysteroscopy.
Methods A total of 120 patients, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, Mallampatti Ⅰ or Ⅱ, receiving hysteroscopy under intravenous anesthesia without intubation were randomly divided into two groups: the control group with mask oxygen-inspiration, oxygen flow 6 L/min, FiO2 45%, and the jet group with oxygen-inspiration by SJV via WEI Nasal Jet tube (WNJ). In the jet group,the WNJ was placed through one of the patient's nostrils for SJV after anesthesia induction, and cross-sectional area of the gastric antrum (CSA-GA) was accomplished by ultrasound before and after SJV. Episodes of SpO2 less than 95%, jaw-lift, pressured mask, nasal bleeding, cough, involuntary limbs swing and hip twist, the other adverse reactions during the operation, CSA-GA before and after SJV were recorded.
Results The episodes of SpO2 < 95% in the jet group were lower than those in the control group (P < 0.05). The difference of CSA-GA before and after jet ventilation was not statistically significant in the jet group. The cases of jaw-lift, pressured mask, cough, involuntary limbs swing and hip twist was significantly lower in the jet group than in the control group (P < 0.05).
Conclusion Supraglottic jet ventilation can effectively maintain oxygenation, without increasing the risk of reflux aspiration.
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