呼吸末正压通气对丙泊酚麻醉下腹腔镜胃癌根治术患者脑氧代谢的影响

发布时间：2019-03-05 16:45

【摘要】：目的:探讨在丙泊酚麻醉下呼吸末正压通气(PEEP)对腹腔镜胃癌根治术患者脑氧代谢的影响。方法:选取本院择期行腹腔镜胃癌根治术患者98例,随机分为观察组和对照组,各49例,在丙泊酚麻醉下观察组采用维持呼吸末正压通气PEEP 5cmH_2O,对照组接受常规通气PEEP 0cmH_2O。比较术前与术后两组患者脑氧代谢指标等。结果:在建立气腹前两组的颈内静脉血氧饱和度(SjvO_2)、动静脉血氧含量差值(CaO_2-CjvO_2)和脑氧摄取率(CerO_2)比较,差异无统计学意义(P0.05);建立气腹1h与2h,观察组患者三项指标均低于对照组,差异均有统计学意义(P0.05)。结论:丙泊酚麻醉下腹腔镜胃癌根治术应用呼吸末正压通气,能降低二氧化碳血症,改善脑过度灌注状态,促进脑血流量和脑氧供需平衡,提高预后效果,改善患者生存质量,值得临床推广。
[Abstract]:Aim: to investigate the effect of positive end respiratory pressure ventilation (PEEP) under propofol anesthesia on cerebral oxygen metabolism in patients undergoing laparoscopic radical gastrectomy. Methods: 98 patients undergoing laparoscopic radical gastrectomy in our hospital were randomly divided into observation group (n = 49) and control group (n = 49). Under propofol anesthesia, the patients in the observation group were treated with maintaining positive end-respiratory pressure (PEEP) 5 cm H _ (2) O _ (2), and the control group (n = 49). The control group received routine ventilation with PEEP 0 cmH ~ (2) O. The indexes of cerebral oxygen metabolism before and after operation were compared between the two groups. Results: there was no significant difference in internal jugular venous oxygen saturation (SjvO_2), arteriovenous oxygen content difference (CaO_2-CjvO_2) and cerebral oxygen uptake rate (CerO_2) between the two groups before the establishment of pneumoperitoneum (P0.05). When pneumoperitoneum was established for 1 h and 2 h, the three indexes in the observation group were lower than those in the control group, and the difference was statistically significant (P0.05). Conclusion: positive end-respiratory pressure ventilation under propofol anesthesia can reduce carbon dioxide, improve cerebral hyperperfusion, promote the balance of cerebral blood flow and cerebral oxygen supply and demand, improve prognosis and improve the quality of life of patients. It is worthy of clinical popularization.
【作者单位】：广西钦州市第一人民医院麻醉科二区;
【分类号】：R614;R735.2

【相似文献】