不同单肺通气模式对胸腔镜手术患者呼吸功能的影响
发布时间：2019-06-19 06:44
【摘要】：目的:通过对不同单肺通气模式下患者呼吸生理变化的观察,为临床麻醉中选择合理的保护性单肺通气策略提供依据。方法:选择择期行胸腔镜辅助下胸科手术患者90例,按不同单肺通气(OLV)模式随机均分为三组。A组行小潮气量定容通气模式(VCV):Vt 6 m L/kg,RR 16次/min,PEEP 0 cm H2O;B组行小潮气量联合低呼气末正压(PEEP)通气模式:Vt 6 m L/kg,RR 16次/min,PEEP 5 cm H2O;C组行定压通气模式(PCV):压力设定为在A组单肺通气模式下达稳定状态时气道峰压,RR 16次/min,PEEP 0 cm H2O。三组分别在OLV前(T0),OLV后30 min(T1)、60 min(T2)、90 min(T3)采集动脉血及中心静脉血行血气分析,同时监测该时点患者的呼吸功能参数,并计算Qs/Qt和[P(a-et)CO2]。结果:OLV后各时点,三组患者的Pa O2下降、Qs/Qt增加(P0.05),但B组、C组优于A组(P0.05);而三组患者的Ppeak均显著升高(P0.05),三组之间无明显差别(P0.05);同时,P(a-et)CO2显著增大(P0.05)。T1、T2时点A组的P(a-et)CO2显著大于B组、C组(P0.05),而T3时点时三组间无明显差别(P0.05);结论 :行单肺通气时,采用PCV模式或小潮气量复合低PEEP模式是有效的保护性单肺通气策略。但随着单肺时间延长,仍需及时进行血气分析,并尽量减少单肺通气的时间。
[Abstract]:Objective: to observe the respiratory physiological changes of patients under different one-lung ventilation modes, and to provide the basis for selecting reasonable protective one-lung ventilation strategy in clinical anesthesia. Methods: 90 patients undergoing thoracoscopic surgery were randomly divided into three groups according to different (OLV) modes of one-lung ventilation. Group A received low tidal volume constant volume ventilation mode (VCV): Vt 6 mL kg, RR 16 times / min,PEEP 0 cm H 2O 鈮，
本文编号：2502177
[Abstract]:Objective: to observe the respiratory physiological changes of patients under different one-lung ventilation modes, and to provide the basis for selecting reasonable protective one-lung ventilation strategy in clinical anesthesia. Methods: 90 patients undergoing thoracoscopic surgery were randomly divided into three groups according to different (OLV) modes of one-lung ventilation. Group A received low tidal volume constant volume ventilation mode (VCV): Vt 6 mL kg, RR 16 times / min,PEEP 0 cm H 2O 鈮，
本文编号：2502177
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