摘要
目的探讨全麻诱导期不同面罩通气压力水平对患者的恶心、呕吐的改善效果。方法研究以2019年6月-2022年6月收治的99例采取腹腔镜手术治疗患者为观察对象,根据全麻诱导期预设的不同面罩通气压力,即:12 cmH_(2)O、15 cmH_(2)O、20 cmH_(2)O,按照随机数字法将患者分为P12通气组、P15通气组、P20通气组,各组均为33例。对比三组患者的临床资料,并根据患者术后48 h的恶心、呕吐反应,将存在恶心、呕吐反应的患者设为观察组,无恶心、呕吐反应的患者设为对照组,分析、比较患者的面罩通气压力水平和胃胀气程度之间的相关性。结果P20通气组患者插管后氧饱和度(SpO_(2))水平比P12通气组和P15通气组高,术后患者出现恶心、呕吐反应的病例数也比P12通气组多,P15通气组、P20通气组患者胃胀气程度则均高于P12通气组(P<0.05),观察组患者面罩通气压力、插管后SpO_(2)水平、胃胀气程度均比对照组高(P<0.05),采用多因素Logistic回归分析,结果显示面罩通气压力水平上升是导致全麻诱导期患者术后出现恶心、呕吐反应的危险因素(P<0.05),且面罩通气压力水平和患者的胃胀气程度成正相关(P<0.01)。结论采取手术治疗的患者在全麻诱导期20 cmH_(2)O面罩通气压力水平下,能显著提升患者的氧饱和度,但会增加患者术后恶心、呕吐反应和胃胀气的风险性。
Objective To explore the effect of different pressure levels of mask ventilation on patients'nausea and vomiting during the induction of general anesthesia.Methods 99 patients treated with laparoscopic surgery from June 2019 to June 2022 were observed.According to different pressures preset of mask ventilation during the induction period of general anesthesia,which were 12 cmH_(2)O,15 cmH_(2)O,20cmH_(2)O,the patients were randomly divided into p12 ventilation group,p15 ventilation group and P20 ventilation group,with 33 cases in each group.The clinical data of the three groups were compared.According to the nausea and vomiting reaction of the patients 48 hours after surgery,the patients with nausea and vomiting reaction were included as the observation group,and the patients without nausea and vomiting reaction were chosen as the control group.The correlation between the levels of mask ventilation pressure and the degree of flatulence was analyzed and compared.Results The oxygen saturation(SpO_(2))level of patients in P20 ventilation group after intubation was higher than that in p12 ventilation group and in p15 ventilation group,and the number of patients with nausea and vomiting after operation was also higher than that in p12 ventilation group.The degree of gastric distention in p15 ventilation group and P20 ventilation group was higher than that in p12 ventilation group(P<0.05).The ventilation pressure of masks,(SpO_(2))level after intubation and the degree of gastric distention in observation group were higher than those in control group(P<0.05),Multivariate logistic regression analysis showed that the rise of mask ventilation pressure was a risk factor for postoperative nausea and vomiting of patients during the induction period of general anesthesia(P<0.05),and the level of mask ventilation pressure was positively correlated with the degree of gastric distention(P<0.01).Conclusion Under the ventilation pressure level of 20 cmH_(2)O mask during the induction period of general anesthesia,patients with surgical treatment can not only significantly improve the oxygen saturation of patients,but also lead to an increase in the risk of postoperative nausea,vomiting and gastric distention.
作者
吴智国
罗芬
WU Zhiguo;LUO Fen(Department of Anesthesiology,the Fourth Division Hospital of Xinjiang Production and Construction Corps,Yining,Xinjiang,835000,China)
出处
《新疆医学》
2023年第10期1241-1244,共4页
Xinjiang Medical Journal
关键词
全麻诱导期
面罩通气压力水平
恶心
呕吐
氧饱和度
胃胀气
Induction period of general anesthesia
Mask ventilation pressure level
Nausea
Vomit
Oxygen saturation
Flatulence of stomach
