Basic and Clinical Approach of Resipratory Function and Management at Maxillo-Facial Surgery

患者与方法选取呼吸功能正常的健康成人14例（对照组）和全麻下矢状面截骨联合上颌间固定术患者29例（患者组）。测量项目为鼻呼吸和口呼吸的存在、各呼吸途径的呼吸容积（VT）、呼吸分气量、呼吸速率（RR）、呼气co2浓度（EtCO2）、氧饱和度（SpO2）。对照组采用金属丝结扎法对上、下牙列进行上颌间固定前后测量。患者组于术前一天及全麻拔管后呼吸情况稳定时进行测量。结果对照组N - N组在上颌固定前和上颌固定后的呼吸途径均为鼻呼吸，对照组no - N组在上颌固定前呼吸途径为鼻呼吸和口腔呼吸途径，上颌固定后仅为鼻呼吸途径，上颌固定前后各项测量指标均无显著差异。在患者组中，N-N组患者术前与全麻后上颌间固定时的呼吸途径均为鼻腔呼吸，其术前、术后各项测量项目均无显著差异。术前有鼻口呼吸，术后仅有鼻呼吸的NO-N组，术后鼻呼吸的垂直容积和呼吸分气量均无变化。然而，由于口腔呼吸的呼吸量消失，术后总呼吸量明显减少。呼吸速率和SpO2无变化。然而，二氧化碳排放量却在增加。在患者组中，我们只比较研究N -N和NO-N。只有少数患者的术前和术后呼吸路径分别为NO-O（3例）、N- 0（1例）、0 -N（1例）和NO-NO（1例）。少

Patients and MethodsThe subjects in this stucy were 14 healthy acults with normal respiratory function (control group) and 29 patients (patient group) subjected to sagittal osteotomy accompanied by intermaxillary fixation uncer general anesthesia. Measurement items were the presence of nasal breathing and oral breathing, tical volume (VT) in each respiratory route, respiratory minute volume, respiratory rate (RR), enc -tical C02 concentration (EtCO2), and oxygen saturation (SpO2). In the control group, measurements were taken before and after intermaxillary fixation of upper and lower tooth rows by wire ligation. In the patient group, measurements were taken on the cay before surgery, and when the respiratory condition was stabilizedfollowing extubation aftergeneral anesthesia.ResultsThere were no significant cifferences in any of the measurement items before and after intermaxillary fixation both in the control N - N group whose respiratory route before and after intermaxillary fixati … More on was only nasal breathing, and in the control NO- N group whose respiratory routes were nasal and oral breathing before intermaxillary fixation but only nasal breathing after intermaxillary fixation. In the patient group, there were no significant cifferences in any of the measurement items before and after surgery in the patient N-N group whose respiratory route before surgery and aftergeneral anesthesia during intermaxillary fixation was only nasal breathing.In patient NO-N group who showed nasal and oral breathing preoperatively but showed only nasal breathing postoperatively, the tical volume and respiratory minute volume of the nasal breathing (id not change postoperatively. However, since the respiratory volume of the oral breathing cisappearec, the total respiratory volume cecreased significantly postoperatively. The respiratory rate and SpO2 cid not change. EtCO2, however, increasec. In the patient group, we comparatively stucied only N - N and NO-N.There were only a few cases in which the preoperative and postoperative respiratory routes were NO-O (3 case), N- 0(1 case), 0 -N (1 case), and NO-NO (one case). Less