高频振荡通气应用于单肺通气对氧合的影响

发布时间：2018-09-11 07:07

【摘要】：目的：比较单肺通气（One-lung ventilation, OLV）时高频振荡通气（High-frequencyoscillatory ventilation, HFOV）和常规机械通气（Conventional mechanical ventilation,CMV）对肺氧合的影响，探讨在OLV中HFOV的可行性。方法：通过自身对照研究，收集符合标准的择期胸外科手术的患者10例，手术麻醉诱导插入双腔支气管后(予右侧卧位，通气肺为右肺)，首先予常规单肺通气20min，然后进行高频振荡通气20min，再改为常规单肺通气20min。分别记录两种通气模式下5min(T1)、10min(T2)、15min(T3)、20min(T4)时的脉氧、血压、心率，然后于20min时抽取桡动脉血行血气分析，记录PaO2、PaCO2、pH、SaO2等指标。结果：当从HFOV改为CMV后，动脉氧分压从（210.90±124.19）mmHg下降到（162.80±102.83）mmHg，，P=0.0230.05，差异具有统计学意义；同时，动脉二氧化碳分压从（60.00±9.04）mmHg下降至（52.60±12.30）mmHg，P=0.0450.05，差异具有统计学意义；两种通气方式PaO2/FiO（2P=0.241）、pH（P=0.286）及SaO（2P=0.173）差异分析无统计学意义。两种通气方式血压、心率比较无明显差异（P0.05）。结论：在单肺通气中，应用HFOV的氧合表现出优于常规容量机械通气模式；同时HFOV在单肺通气中与CMV相比对血流动力学无明显影响。
[Abstract]:Objective: to compare the effects of high frequency oscillatory ventilation (High-frequencyoscillatory ventilation, HFOV) and conventional mechanical ventilation (Conventional mechanical ventilation,CMV) on pulmonary oxygenation during single lung ventilation (One-lung ventilation, OLV) and to explore the feasibility of HFOV in OLV. Methods: a self-controlled study was conducted in 10 patients undergoing elective thoracic surgery according to the criteria. Anesthesia induction was performed after insertion into the double-lumen bronchus (right lateral position). One lung was ventilated for 20 minutes, then the high frequency oscillatory ventilation was performed for 20 minutes, and then the routine single lung ventilation for 20 minutes. Pulse oxygen, blood pressure and heart rate were recorded at 5min (T 1) 10 min (T 2) and 15 min (T 3) and 20 min (T 4) under two ventilation modes respectively. Radial artery blood was extracted at 20min for blood gas analysis and PaO2,PaCO2,pH,SaO2 was recorded. Results: after changing from HFOV to CMV, the arterial partial pressure of oxygen decreased from (210.90 卤124.19) mmHg to (162.80 卤102.83) mmHg,P=0.0230.05, and the arterial partial pressure of carbon dioxide decreased from (60.00 卤9.04) mmHg to (52.60 卤12.30) mmHg,P=0.0450.05,. There was no significant difference between PaO2/FiO (2P=0.241) and SaO (2P=0.173) in pH (P0. 286) and SaO (2P=0.173). There was no significant difference in blood pressure and heart rate between the two ventilation modes (P0.05). Conclusion: the oxygenation of HFOV in single lung ventilation is superior to that of conventional volume mechanical ventilation, and HFOV has no significant effect on hemodynamics compared with that of CMV in single lung ventilation.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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