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目的研究低浓度氧气和纯氧对全麻下行气管插管择期手术患儿肺交换功能的影响。方法选取2014年2月至10月期间接诊的80例全麻下行气管插管择期手术患儿作为研究对象,将其随机分为两组,各40例。研究组患儿采用氧浓度为22%的低浓度氧辅助治疗(Fi O2=22%),对照组患儿采用氧浓度为100%的纯氧辅助治疗(Fi O2=100%)。治疗前后检测并记录两组患儿的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(Sp O2)、动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、氧合指数(Pa O2/Fi O2)、肺泡动脉氧压差(PA-a O2)、呼吸指数(RI)、动脉肺泡氧分压比(Pa O2/PAO2)等肺交换指标值及带管时间、ICU时间、住院时间等相关治疗时间,并对结果进行比较。结果在T1时间点,两组患儿的MAP、HR差异均无统计学意义(P均>0.05);经过治疗,T2时间点两组患儿的MAP、HR较T1时间点均有明显下降(P均<0.05),但两组T2时间点的MAP、HR比较差异无统计学意义(P均>0.05)。在T2时间点,研究组患儿的Sp O2、Pa O2、PA-a O2、RI、Pa O2/PAO2等指标与对照组患儿相比差异均具有统计学意义(P均<0.01),而两组患儿的Pa CO2及Pa O2/Fi O2比较差异无统计学意义(P均>0.05)。研究组患儿的带管时间、ICU时间及住院时间等均明显短于对照组(P均<0.05)。结论对于肺交换功能正常的患儿,在麻醉过程中吸入22%低浓度的氧气,不会导致低氧血症的发生,反而避免了由于吸入高浓度氧对肺交换功能的影响。
Objective To study the effect of low concentration of oxygen and pure oxygen on the lung exchange function in children undergoing general anesthesia for elective tracheal intubation. Methods Eighty children undergoing general anesthesia for tracheal intubation undergoing elective surgery between February 2014 and October 2014 were selected as study subjects and randomly divided into two groups of 40 patients. The study group used a low oxygen concentration of 22% (Fi O2 = 22%) and a control group (100%) of pure oxygen with a oxygen concentration of 100%. Before and after treatment, mean arterial pressure (MAP), heart rate (HR), Sp O2, Pa O2, PaCO2, , Pa O2 / Fi O2, PA-a O2, RI and Pa O2 / PAO2, Time, ICU time, hospitalization time and other related treatment time, and the results were compared. Results There was no significant difference in MAP and HR between the two groups (all P> 0.05) at T1 time point. After treatment, MAP and HR in both groups at T2 were significantly lower than those at T1 P <0.05). However, there was no significant difference in MAP and HR between the two groups at T2 (P> 0.05). At T2, there were significant differences in Sp O2, Pa O2, PA-a O2, RI, Pa O2 / PAO2 among children in the study group compared with those in the control group (all P <0.01) There was no significant difference in PaCO 2 and Pa O 2 / Fi O 2 between two groups (P> 0.05). The study group was significantly shorter than the control group in the duration of catheterization, ICU and hospital stay (all P <0.05). Conclusions In children with normal lung exchange, inhalation of 22% oxygen at a low concentration during anesthesia does not lead to hypoxemia but instead avoids the effects of high concentrations of oxygen on lung exchange.