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目的探讨呼气末正压通气(PEEP)对小儿全身麻醉诱导期无通气时限的影响及与年龄和体重的相关性。方法选取2013年7月-2014年7月该院收治的行全身麻醉择期手术的患儿130例为研究对象,随机分为研究组和对照组,每组各65例。两组患儿均给予丙泊酚、罗库溴铵以及芬太尼,自主呼吸减弱以后对照组给予面罩给氧,并给予压力控制模式辅助机械通气,研究组在对照组的基础上加用PEEP,两组机械通气的时间均设定为3 min,记录两组机械通气停止到脉搏的血氧饱和度下降到99%(t_(99))、95%(t_(95))以及90%(t_(90))的时间。两组小儿无创通气时限(t_(90))和年龄、体重的相关性分析应用线性回归分析法。结果研究组t_(99)、t_(95)和t_(90)分别为(129.8±23.1)s、(162.4±12.9)s和(178.2±14.2)s,对照组t_(99)、t_(95)和t_(90)分别为(134.7±21.9)s、(171.4±16.8)s和(183.1±13.9)s,两组比较,差异无统计学意义(P<0.05);对照组年龄(R~2=0.896)、体重(R~2=0.879)与无通气时限线性拟合性较好,研究组年龄(R~2=0.612)、体重(R~2=0.409)与无通气时限线性拟合性减小;研究组相关系数0.769和0.651显著低于对照组相关系数0.952和0941,两组比较,差异有统计学意义(P<0.05)。结论 PEEP对小儿全身麻醉诱导期无通气时限的影响较小,可以减小年龄和体重对其的影响。
Objective To investigate the effect of end-expiratory positive pressure ventilation (PEEP) on the duration of non-ventilated period in pediatric general anesthesia induction and its relationship with age and body weight. Methods A total of 130 children undergoing general anesthesia and elective surgery admitted to our hospital from July 2013 to July 2014 were selected as study subjects and randomly divided into study group and control group with 65 cases in each group. The two groups of children were given propofol, rocuronium and fentanyl, decreased spontaneous breathing after the control group were given oxygen mask, and given pressure control mode assisted mechanical ventilation, the study group in the control group based on the use of PEEP , The duration of mechanical ventilation in both groups was set at 3 min. The oxygen saturation between mechanical ventilation stopped to pulse decreased to 99% (t 99), 95% (t 95) and 90% t_ (90)). Two groups of pediatric noninvasive ventilation time (t_ (90)) and age, weight of the correlation analysis using linear regression analysis. Results The values of t_ (99), t_ (95) and t_ (90) in the study group were (129.8 ± 23.1) s, (162.4 ± 12.9) s and (178.2 ± 14.2) ) And t_ (90) were (134.7 ± 21.9) s, (171.4 ± 16.8) s and (183.1 ± 13.9) s respectively. There was no significant difference between the two groups (P <0.05) (R 2 = 0.896) and body weight (R 2 = 0.879) were better than those without ventilation (P <0.05) The correlation coefficient between the two groups was significantly lower (0.769 and 0.651, 0.952 and 0.941, respectively) (P <0.05). Conclusions PEEP has little effect on the duration of no-ventilatory time during induction of general anesthesia in children, and can reduce the influence of age and weight on PEEP.