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目的观察在无痛人流术中,丙泊酚静脉麻醉诱导期同步深呼吸预吸氧防止低氧血症的效果。方法将无痛人流手术120例随机分成3组,A组(36例),丙泊酚注射同时让患者做4次深呼吸;B组(37例),注射丙泊酚的同时要求患者做8次深呼吸;对照组(37例),保持平静呼吸。期间由一名助手保持患者头颈正中后仰位(抬下颌,闭合口唇)保持呼吸道通畅。观察术中丙泊酚用药量及循环改变情况、发生呼吸暂停、低氧血症例数,低氧血症持续时间以及自主呼吸恢复情况等。结果 3组术中丙泊酚用量无显著性差异(P>0.05)。3组静脉麻醉后血压下降较明显,组内比较有显著性差异(P<0.01),但组间比较无显著性差异(P>0.05)。术中低氧血症发生率分别是25.00%,48.65%,37.84%,B组高于A组(P<0.05)。术中呼吸暂停发生率分别为30.56%,72.97%,29.73%,B组高于A组和对照组(P<0.01)。B组低氧血症病例主要是由于呼吸暂停所引起,而且低氧血症持续时间长于A组(P<0.05)。A组与对照组比较,低氧血症及呼吸暂停发生率无统计学差异(P>0.05)。结论丙泊酚静脉麻醉诱导期同步深呼吸达不到真正意义的麻醉前预吸氧效果,甚至会增加呼吸抑制的发生,临床应注意。
Objective To observe the effect of prophylactic prophylaxis of hypoxemia during propofol intravenous anesthesia in painless abortion. Methods 120 patients with painless abortion were randomly divided into 3 groups: group A (36 cases), propofol injection and deep breath for 4 times; group B (37 cases) Take a deep breath; control group (37 cases), keep calm breathing. During the period, an assistant held the patient’s head and neck backwards (jaw lift, closed lips) to keep the airway open. Observation of intraoperative propofol dosage and circulation changes, the occurrence of apnea, hypoxemia cases, duration of hypoxemia and spontaneous breathing recovery and so on. Results There was no significant difference in the amount of propofol between the three groups (P> 0.05). The decrease of blood pressure after intravenous anesthesia was more obvious in three groups (P <0.01), but there was no significant difference between the two groups (P> 0.05). The incidences of intraoperative hypoxemia were 25.00%, 48.65% and 37.84% respectively, which were significantly higher in group B than those in group A (P <0.05). The incidences of intraoperative apnea were 30.56%, 72.97%, 29.73% respectively, which were higher in group B than those in group A and control group (P <0.01). The hypoxemia in group B was mainly caused by apnea, and the duration of hypoxemia was longer than that in group A (P <0.05). There was no significant difference in hypoxemia and apnea between group A and control group (P> 0.05). Conclusion Propofol intravenous anesthesia induction period of deep breathing can not reach the real sense of pre-anesthesia pre-oxygen effect, and even increase the incidence of respiratory depression, the clinical should be noted.