朱金有

【摘要】 目的：探讨分析高頻喷射通气联合纤支镜在甲状腺肿瘤患者气管插管时的应用效果。方法：选取2019年1月-2020年6月本院开展的甲状腺手术60例次进行本研究。应用随机数字表法将患者分为两组，两组均实施活检孔纤维支气管镜引导，经口气管内插管静脉复合全麻。对照组无高频喷射通气，研究组实施高频喷射通气。对比两组不同时间点平均动脉压（MAP）、血氧饱和度（SpO2）与心率水平、一次插管成功率与并发症发生情况、不同时间点血气指标水平及通气满意度。结果：两组T1时MAP、SpO2与心率水平比较，差异均无统计学意义（P>0.05）;研究组T2、T3、T4时MAP水平均低于对照组，SpO2与心率水平均高于对照组（P<0.05）。研究组一次插管成功率为96.7%，高于对照组的60.0%（P<0.05）;研究组并发症发生率低于对照组（P<0.05）。两组T1时PaO2、PaCO2水平比较，差异均无统计学意义（P>0.05）;研究组T3、T4时PaO2水平均高于对照组，PaCO2水平均低于对照组（P<0.05）。研究组通气总满意度96.7%，高于对照组的80.0%（P<0.05）。结论：巨大甲状腺肿瘤压迫气管患者进行纤维支气管镜经口全麻气管插管中给予高频喷射通气辅助通气，可维持并提升患者MAP、SpO2及心率水平，还可维持并改善血气指标水平，提升患者通气整体满意度，降低并发症发生率，应用效果理想，值得借鉴。

【关键词】 高频喷射通气 纤维支气管镜 巨大甲状腺肿瘤 压迫气管 全麻气管插管 氧饱和度

Application of High Frequency Jet Ventilation Combined with Fiberoptic Bronchoscopy in General Anesthesia Tracheal Intubation in Patients with Huge Thyroid Tumor/ZHU Jinyou. //Medical Innovation of China， 2021， 18（33）： -136

[Abstract] Objective： To investigate and analyze the effect of high frequency jet ventilation combined with fiberoptic bronchoscopy in general anesthesia tracheal intubation in patients with huge thyroid tumor. Method： A total of 60 cases of thyroid surgery carried out in our hospital from January 2019 to June 2020 were selected for this study. The patients were divided into two groups by random number table method. Both groups were guided by biopsy hole fiberoptic bronchoscope， oral endotracheal intubation and intravenous compound general anesthesia. The control group was given no high-frequency jet ventilation， and the study group was implemented high-frequency jet ventilation. The mean arterial pressure （MAP）， blood oxygen saturation （SpO2） and heart rate， success rate of one-time intubation and complications， blood gas index levels and ventilation satisfaction at different time points were compared between two groups. Result： There were no significant differences in MAP， SpO2 and heart rate between two groups at T1 （P>0.05）. The levels of MAP at T2， T3 and T4 in the study group were lower than those in the control group， and the levels of SpO2 and heart rate were higher than those in the control group （P<0.05）. The success rate of one-time intubation in the study group was 96.7%， which was higher than 60.0% in the control group （P<0.05）. The incidence of complications in the study group was lower than that in the control group （P<0.05）. There were no significant difference in the levels of PaO2 and PaCO2 between two groups at T1 （P>0.05）. The levels of PaO2 in the study group at T3 and T4 were higher than those in the control group， and the levels of PaO2 were lower than those in the control group （P<0.05）. The total satisfaction with ventilation in the study group was 96.7%， which was higher than 80.0% in the control group （P<0.05）. Conclusion： high frequency jet ventilation assisted ventilation can maintain and improve the levels of MAP， SpO2 and heart rate， maintain and improve the level of blood gas indicators， improve the overall ventilation satisfaction of patients and reduce the incidence of complications. The application effect is ideal and worthy of reference.

[Key words] High frequency jet ventilation Fiberoptic bronchoscopy Huge thyroid tumor Compressed trachea General anesthesia tracheal intubation Oxygen saturation

First-author’s address： Ganzhou People’s Hospital， Ganzhou 341600， China

doi：10.3969/j.issn.1674-4985.2021.33.032

纖维支气管镜又被称作纤支镜，在临床呼吸系统疾病及肺部疾病的检查、诊治中必不可少，已被临床广泛应用[1]。改善患者的就医体……