单肺通气时吸入不同浓度氧对围术期氧合的影响

发布时间：2018-08-18 21:35

【摘要】：目的探讨食管癌患者术中单肺通气(OLV)时吸入不同浓度氧(FiO2)对围术期氧合的影响。方法选择拟行左侧剖胸食管癌根治术患者90例,随机均分为三组,每组30例,分别在OLV时将FiO2设定为60%(L组)、75%(M组)和90%(C组)。分别在麻醉前(T0)、OLV前(T1)、OLV 30min(T2)、60min(T3)、120min(T4)及恢复双肺通气(TLV)后30min(T5)、术后24h(T6)抽取动脉血测PaO2、SaO2、pH、PaCO2,计算氧合指数(PaO2/FiO2),同时持续监测SpO2、PETCO2、气道峰压(Ppeak)、气道平台压(Pplat)和气道顺应性(Cldyn)。结果 L组、M组、C组分别有6例、1例、1例患者在OLV 1h内SpO2下降到95%以下,被剔除出组。T2~T4时L组PaO2明显低于M、C组,M组明显低于C组(P0.05);T2~T4时L组SaO2、SpO2明显低于M、C组(P0.05)。三组各时点PaO2/FiO2、pH、PaCO2、PETCO2差异无统计学意义。结论左侧剖胸行食管癌根治术患者术中OLV时FiO2降低到75%时循环稳定,氧合充分。
[Abstract]:Objective to investigate the effect of inhalation of different concentrations of oxygen (FiO2) on perioperative oxygenation in patients with esophageal cancer during single lung ventilation (OLV). Methods A total of 90 patients undergoing radical resection of esophageal carcinoma were randomly divided into three groups, 30 patients in each group. The FiO2 was set at 60% (group L) and 90% (group C) at OLV time, respectively. Before anesthesia (T 0), 60 minutes (T 2) and 120 minutes (T 4), 30min (T 5) were obtained before anesthesia (T 0) and 60 minutes (T 2) (T 3) before anesthesia, respectively. Arterial blood samples were taken 24 hours after operation (T 6) to measure PaO2, SaO2, pH and Paco 2. The oxygenation index (PaO2/FiO2) was calculated. SpO2PETCO 2 was continuously monitored. The peak pressure of airway pressure, (Pplat), and airway compliance (Cldyn). Were measured. Results the SpO2 of 1 patient in group C decreased to less than 95% within 1 hour of OLV, and the PaO2 of group L was significantly lower than that of group C (P0.05) at the time of removal of T2T4. The PaO2 of group L was significantly lower than that of group C (P0.05). There was no significant difference in Pao _ 2 / FiO _ 2 and Paco _ 2 PETCO _ 2 between the three groups at different time points. Conclusion the FiO2 of the patients undergoing radical esophagectomy is stable and oxygenation is sufficient when the FiO2 is reduced to 75.
【作者单位】：上海梅山医院麻醉科;江苏省肿瘤医院麻醉科;
【基金】：南京市卫生局科技发展项目(YKK10178) 上海梅山钢铁公司科研课题(K14TMSL550)
【分类号】：R614

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