小潮气量间歇正压通气对老年妇科恶性肿瘤患者机体炎症因子及氧供需平衡的影响

发布时间：2018-12-15 08:18

【摘要】：目的探讨小潮气量间歇正压通气(LTV-IPPV)对老年妇科恶性肿瘤患者机体炎症因子及氧供需平衡的影响。方法选取接受宫颈癌腹腔镜根治术患者105例,根据随机数字表法分成A、B、C 3组各35例。术中麻醉过程中,在气管插管后实施间歇正压通气,其中A组潮气量为6 ml/kg,B组为10 ml/kg,C组为12 ml/kg。对比各组机体的炎症因子水平、平均动脉压(MAP)、心率(HR)、血红蛋白(Hb)水平及氧代谢指标水平。结果通气60 min(T1)时B、C两组白细胞介素(IL)-8及肿瘤坏死因子(TNF)-α及C组IL-10水平均显著高于A组,拔管15 min后(T2)时B、C两组IL-8、IL-10及TNF-α水平均显著高于A组(均P0.05)。各组麻醉诱导前(T0)、T1、T2时MAP、HR及Hb水平差异均无统计学意义(均P0.05)。各组T1、T2时混合静脉的血氧饱和度(Sv O2)水平较T0时明显升高,氧摄取率(ERO2)水平较T0时明显降低(均P0.05)。结论 LTV-IPPV能够较好地降低老年妇科恶性肿瘤患者机体内的炎症因子水平,且不会影响机体的氧供需平衡。
[Abstract]:Objective to investigate the effect of intermittent positive pressure ventilation (LTV-IPPV) with small tidal volume on inflammatory factors and oxygen supply and demand balance in elderly patients with gynecologic malignancy. Methods 105 patients undergoing laparoscopic radical resection of cervical cancer were randomly divided into three groups: group A (n = 35) and group C (n = 35). During anesthesia, intermittent positive pressure ventilation was performed after endotracheal intubation, with tidal volume of 6 ml/kg,B in group A and 10 ml/kg,C in group A, 12 ml/kg. in group A. The levels of inflammatory factors, (MAP), heart rate, (HR), hemoglobin (Hb) and oxygen metabolism were compared. Results the levels of interleukin (IL) 8 and tumor necrosis factor (TNF)-伪 and IL-10 in group C were significantly higher than those in group A at 60 min (T1), and IL-8, levels in group C were significantly higher than those in group C at 15 min after extubation (T2). The levels of IL-10 and TNF- 伪 were significantly higher than those of group A (P0.05). There was no significant difference in MAP,HR and Hb levels before anesthesia induction (T 0) and T 1 T 2 (P 0.05). The level of blood oxygen saturation (Sv O 2) and oxygen uptake rate (ERO2) of mixed vein in T 1 T 2 group were significantly higher than those in T 0 group (P 0.05). Conclusion LTV-IPPV can decrease the level of inflammatory factors in the elderly patients with gynecologic malignant tumor, and it will not affect the balance of oxygen supply and demand.
【作者单位】：江西省妇幼保健院麻醉科;
【基金】：江西省自然科学基金资助项目(No.20132BAB205042)
【分类号】：R614;R737.3

【相似文献】