麻醉苏醒期应用不同氧流量置换七氟醚对全麻病人苏醒影响.pdfVIP

目 录 一、摘要 中文论著摘要?????????????????．1 英文论著摘要?．．．．．．?????．．????????．．2 二、英文缩略语?????．??????．???．??．．．4 三、论文 肖f言???．???．．?????????????5刚舌 a 资料与方法．??????????????．．??．．．5 结果????．．．．．????．．??????????6 讨{仑???????????．????????．．9 结论?．．．．?????．．．?????．．．??．．?．．．．．11 四、本研究创新性的自我评价?????????????．．12 五、参考文献???????．．??????????．．13 六、附录 综述???????????．????????．14 在学期间科研成绩????????????．???．22 致谢???????????????????．．23 个人简介?．??????．??．????????．24 ·中文论著摘要· 麻醉苏醒期应用不同氧流量置换七氟醚对全麻病人苏 醒的影响 目 的 探讨不同氧流量机械通气对七氟醚全麻病人苏醒的影响。 方法 择期全麻下行甲状腺肿物切除手术病人100例，ASA I级或II级，年龄30一60 岁。随机分为四组，每组术毕氧流量分别为0．05Lkg—Imin一1(I组)，0．1 Lkg-lmin-1， (II组)，O．15 Lkg．1min．1(III组)，0．2 Lkg一1min-1(IV组)，其余各呼吸参数保持 不变。术中连续监测血压、心率、心电图及血氧饱和度，连续监测吸入七氟醚浓 度(Fi)和呼气末七氟醚浓度(Fa)，记录停吸前即刻七氟醚浓度(Fao)及每隔一分 钟的Fa，直至苏醒，并计算各时点的Fa／Fao，记录苏醒时间和术后躁动出现的例数。 记录停药时(TO)、停药5min(T5)、停药10min(T10)各时点血气分析结果及 气道峰压值。 结 果 I组患者睁眼时间拔管时间与其他三组相比均延长，Ⅳ组患者躁动发生率较 其他三组高。各氧流量组患者气道压变化无明显差异，Ⅳ组患者停药10分钟与停 药即刻相比PH值明显增高，PaC02明显降低。 结论 术毕氧流量(0．1 Lkg．1min．1)可以使患者迅速苏醒，减少气源浪费，术后躁 动发生率低，对患者内环境影响小，是较为理想的氧流量选择。 关键词 氧流量七氟醚苏醒 英文论著摘要 The Influence of Different Oxygen Flow on Recovery Experience during Sevoflurane General Anesthesia obj ective To investigate the effects of different fresh gas flow rates of oxygen on recovery in patients with Sevoflurane general anesthesia． Methods 1 00 ASA I-II patients，aged 30-60yrs，who were scheduled to undergo thyroid surgery under sevoflurane general anesthesia，were randomly divided into four groups according to different fresh gas fow rate：0．05 Lkg’1min～in Group I．O．1 Lkg‘1min一1 in Group II，0．1 5 Lkg‘1min。1 in GrouplII，0．2 min Lkg’1min’1 in Groupiv．The rest of the respiratory parameters were adjusted to the similar level．Blood pressure，heart rate， ECG，oxygen saturation，inhaled sevoflurane concentration(Fi)and sevoflurane concentration(Fa)were monitored throughout the surgery，and the sevoflurane concentration(Fao)before stop—flow and Fa of every minute were also noted until awake．We calculated the Fa／Fao of each point，and recorded the awakening time， incidence o