[1]黄剑华 徐战平* 钟羽翔 赵朋朋 麦源 韦巍.低呼吸频率低潮气量通气全麻用于输尿管软镜碎石术的随机对照研究[J].中国微创外科杂志,2019,01(10):870-873.
 Huang Jianhua,Xu Zhanping,Zhong Yuxiang,et al.Application of Low Frequency and Low Tidal Volume Ventilation Mode in Flexible Ureteroscopic Lithotripsy: a Randomized Controlled Trial[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):870-873.
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低呼吸频率低潮气量通气全麻用于输尿管软镜碎石术的随机对照研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年10期
页码:
870-873
栏目:
临床论著
出版日期:
2019-10-25

文章信息/Info

Title:
Application of Low Frequency and Low Tidal Volume Ventilation Mode in Flexible Ureteroscopic Lithotripsy: a Randomized Controlled Trial
作者:
黄剑华 徐战平* 钟羽翔 赵朋朋 麦源 韦巍
(广东省佛山市中医院泌尿外科,佛山528000)
Author(s):
Huang Jianhua Xu Zhanping Zhong Yuxiang et al.
Department of Urology, Foshan Hospital of TCM, Foshan 528000, China
关键词:
输尿管软镜通气模式肾结石
Keywords:
Flexible ureteroscopeVentilation modeRenal stone
文献标志码:
A
摘要:
目的研究气管插管全麻下低呼吸频率(6~8次/min)低潮气量(5~6 ml/kg)通气模式能否提高输尿管软镜碎石手术(flexible ureteroscopic lithotripsy,fURSL)的效率及安全性。方法选择2018年7~12月择期全身麻醉下行fURSL的肾结石82例,随机分为2组,各41例。对照组采用标准通气模式(呼吸频率10~15次/min,潮气量6~8 ml/kg),研究组采用低呼吸频率低潮气量通气模式,比较2组碎石、清石效率及相关并发症发生率。结果与对照组比较,研究组的碎石效率、清石效率、操作效率和手术效率更高[(92.3±20.1) vs. (70.1±20.9) mm3/min,t=3.905,P=0.000;(99.2±27.8) vs. (76.6±18.0) mm3/min,t=3.474,P=0.001;(47.5±11.2) vs. (36.3±8.9) mm3/min,t=4.011,P=0.000;(41.6±10.2) vs. (32.3±8.1) mm3/min,t=3.636,P=0.001],但操作结束时呼气末CO2分压更高[(48.1±3.3) vs. (38.7±2.3) mm Hg,t=11.726,P=0.000]。2组术后4周结石清除率均为95.1%(39/41),无统计学差异。研究组麻醉、手术并发症无明显增加。结论低呼吸频率低潮气量通气模式全麻可显著提高fURSL的手术效率,且不增加麻醉、手术并发症。
Abstract:
ObjectiveTo investigate whether general anesthesia with low ventilation (respiratory rate 6-8/min and tidal volume 5-6 ml/kg) could improved the efficiency and safety of flexible ureteroscopic lithotripsy (fURSL).MethodsIn this randomized controlled study we enrolled 82 patients who were scheduled for fURSL under general anesthesia in our hospital. The patients were randomly divided into two groups, with 41 patients in each group. The control group was selected to receive standard ventilation (respiratory rate 10-15/min and tidal volume 6-8 ml/kg) and the experiment group received low ventilation. Comparisons between the two groups were made with respect to stone fragmentation rate, stone removal rate, and related complications rate.ResultsThe fragmentation rate, removal rate, processing rate and operating rate of the experiment group were significantly higher than those of the control group [(92.3±20.1) vs. (70.1±20.9) mm3/min, t=3.905, P=0.000; (99.2±27.8) vs. (76.6±18.0) mm3/min, t=3.474, P=0.001; (47.5±11.2) vs. (36.3±8.9) mm3/min, t=4.011, P=0.000; (41.6±10.2) vs. (32.3±8.1) mm3/min, t=3.636, P=0.001]. The partial pressure of end-tidal CO2 was significantly higher in the experiment group than the control group [(48.1±3.3) vs. (38.7±2.3) mm Hg, t=11.726, P=0.000], however. The overall stone-free rate of the two groups was 95.1% (39/41) at 4 weeks postoperatively, without significant difference between the two groups. ConclusionsLow frequency and low tidal volume ventilation mode during fURSL has a significant positive impact on the improvement of surgical performance and effectiveness. It does not negatively affect the patient’s safety related to anesthesia and surgery.

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备注/Memo

备注/Memo:
*通讯作者,E-mail:xuzhanping2004@163.com
更新日期/Last Update: 2020-01-09