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|本期目录/Table of Contents|

J-Ⅲ型袖珍急救呼吸机在心脏手术后患者转运中的应用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第3期
页码:
351-353
栏目:
临床研究
出版日期:
2008-05-20

文章信息/Info

Title:
Application of J-Ⅲ miniventilator to postoperative transportation for patients undergoing cardiac surgery
作者:
胡胜1; 熊利泽1; 陈绍洋1; 陈敏1; 朱萧玲1; 侯立朝1; 柯长山2
1.第四军医大学西京医院麻醉科，陕西 西安710032； 2.安康职业技术学院附属医院麻醉科,陕西 安康 726000
Author(s):
HU Sheng;  XIONG Lize;  CHEN Shaoyang;  CHEN Min;  ZHU Xiaoling;  HOU Lichao;  KE Changshan
Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
关键词:
心脏手术; 体外循环; 机械通气; 呼吸机
Keywords:
cardiac operation;  extracorporeal circulation; mechanical ventilation; ventilator
分类号:
R654.2
DOI:
-
文献标识码:
A
摘要:
目的 比较J-Ⅲ型袖珍急救呼吸机和手控呼吸器在体外循环心脏手术后患者转运中的应用效果。方法 40例ASAⅢ～Ⅳ级体外循环心脏手术后患者，转运至ICU途中随机分为手控组和机控组，每组20例。手控组在转运途中使用手控呼吸器，机控组在转运途中使用J-Ⅲ型袖珍急救呼吸机，观察两种呼吸支持方式对血流动力学参数及血气分析指标的影响。结果 ① 与术毕比较，手控组ICU时的心率（HR）增快，机控组HR无显著变化；机控组入ICU时的HR、中心静脉压（CVP）低于手控组（P<0.01）；②两组术毕转运前动脉血氧分压（PaO2）高于转运至ICU时的PaO2，差异有显著性（P<0.01）；pH、二氧化碳分压（PaCO2）和剩余碱（BE）差异无显著性。术毕和转运至ICU时血气分析指标两组间比较差异无统计学意义。结论 J-Ⅲ型袖珍急救呼吸机用于体外循环心脏手术后患者转运途中呼吸支持，简便易行，安全可靠。
Abstract:
AIM To compare the effects of J-Ⅲ minirespirator and manual respirator applied to the postoperative transportation of patients undergoing cardiac surgery. METHODS Forty ASA class Ⅲ-Ⅳ patients after surgery for heart diseases were randomly divided into two groups (n=20 each) during transportation. In group A, a manual respirator was applied and in group B, a J-Ⅲ miniventilator was applied. Hemodynamic parameters, airway pressures and arterial blood gas were measured. RESULTS ① The heart rate in the patients of group A at ICU was significantly increased but no significant changes were observed in the patients of group B compared with that before transportation (P<0.05). The heart rate and CVP in the patients of group B were lower than those in the patients of group A after transportation (P<0.01). ②PaO2 at the end of operation in both groups was respectively higher than that after transportation (P<0.01). But no significant changes were found in pH, PaCO2 and BE. No significant differences were found in pH, PaO2, PaCO2 and BE before transportation and after transportation between the two groups. CONCLUSION J-Ⅲ mini-ventilator is easy to operate and would not significantly affect hemodynamics and arterial blood gas during the postoperative transportation. It can be safely used in the postoperative transportation for patients undergoing cardiac surgery.

参考文献/References

［1］ Bardell T, Legare JF, Buth KJ, et al. ICU readmission after cardiac surgery ［J］. Eur J Cardiothorac Surg, 2003,23(3):354-359.

［2］ Currey J, Botti M. The haemodynamic status of cardiac surgical patients in the initial 2h recovery period ［J］. Eur Cardiovasc Nurs, 2005, 4(3):207-214.

［3］ 周小香，陈昕，梁艳娉，等. 简易呼吸器辅助通气在危重病人抢救中的应用［J］. 中华医学写作杂志， 2003, 10(19):1767-1768.

［4］ 孟庆友，卜祥振，拜和平，等. 袖珍呼吸机的研制与应用［J］. 人民军医， 1999, 42(11)：645-646.

［5］ 孟庆友，卜祥振，拜和平，等. J-Ⅲ型袖珍呼吸机的研制与应用［J］. 医疗装备， 1999， 12(7):5-6.

［6］ 王建新，王小玲，王黎梅.手控呼吸器的使用方法和效能关系［J］.中华急诊医学杂志， 2002， 11(5):353.

［7］ 刘刚, 董穗欣, 万峰, 等. 非体外循环冠状动脉旁路移植术后呼吸机支持对血流动力学的影响［J］. 北京医学, 2005, 27(6):380.

备注/Memo

备注/Memo:
收稿日期：2007-02-12.通讯作者：熊利泽，主任医师，教授，主要从事中枢神经保护研究Email:lxiong@fmmu.edu.cn 作者简介：胡胜，主治医师，博士生Email:husheng51@fmmu.edu.cn 作者简介：肖军，副主任医师，硕士Email:xxxjjj6288@sina.com
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