Cormack John R, Hui Raymond, Olive David, Said Simone
St. Vincent's Hospital, Melbourne, Australia.
Urology. 2007 Jul;70(1):7-10. doi: 10.1016/j.urology.2007.03.045.
To compare high-frequency jet ventilation (HFJV) with spontaneous ventilation (SV) in general anesthesia for extracorporeal shock wave lithotripsy (ESWL).
We conducted a retrospective review of 91 consecutive patients undergoing either HFJV with a Ben Jet airway or SV with a laryngeal mask airway, comparing the total number of shocks for stone ablation and the time in the post-anesthetic care unit between groups. Stone ablation rates on postoperative x-rays were compared.
The HFJV group needed significantly fewer shocks for stone ablation (median, 2000 versus 3000, P = 0.0001), and there was no difference in post-anesthetic care unit time. No patient in either group had significant clinical signs of ESWL-related tissue trauma. There was no difference in stone ablation rates on follow-up x-ray (HFJV 77% versus SV 74%).
This study supports the use of HFJV as a ventilation mode for ESWL when general anesthesia is chosen. Similar stone fragmentation rates can be achieved with fewer shocks, which may have beneficial effects, such as less pain and nausea, requiring further study.
比较全身麻醉下高频喷射通气（HFJV）与自主通气（SV）用于体外冲击波碎石术（ESWL）的效果。
我们对91例连续接受Ben Jet气道HFJV或喉罩气道SV的患者进行了回顾性研究，比较两组间结石消融所需的总冲击次数以及麻醉后监护病房的停留时间。比较术后X线片上的结石消融率。
HFJV组结石消融所需的冲击次数显著更少（中位数，2000次对3000次，P = 0.0001），麻醉后监护病房停留时间无差异。两组均无患者出现ESWL相关组织创伤的明显临床体征。随访X线片上的结石消融率无差异（HFJV组77%对SV组74%）。
本研究支持在选择全身麻醉时将HFJV用作ESWL的通气模式。采用较少的冲击次数可实现相似的结石破碎率，这可能具有有益效果，如减轻疼痛和恶心，尚需进一步研究。
