摘要
目的通过观察单肺通气患者术中氧合指数(oxygenation index,OI)、呼吸指数(respiratory index,RI)及动态肺顺应性(dynamic lung compliance,Cdyn)的变化,探讨高渗氯化钠溶液对术中单肺通气患者的肺保护作用。方法选择2009年12月-2011年2月完成的美国麻醉师协会分级为Ⅰ～Ⅲ级,心肺功能筛查、血常规、肝肾功能及凝血功能无明显异常,拟在全麻双腔气管插管下行开胸手术,术中需行单肺通气患者60例,随机分为高渗氯化钠组(A组)和对照组(B组),每组30例。A组在开始单肺通气后30min快速输注7.5%高渗氯化钠溶液2mL/kg,15min内输注完毕,B组输注等量生理盐水,分别记录输注前(T1)、输注完毕时(T2)、输注后30min(T3)、输注后1h(T4)的OI、RI及Cdyn变化,并比较两组各时间点生命体征变化。结果两组患者OI、RI及Cdyn在T1、T2时差异无统计学意义(P>0.05);两组患者不同时间点平均动脉压、心率、脉搏血氧饱和度、中心静脉压、呼气末CO2分压比较差异无统计学意义(P>0.05);A组患者在T3、T4时的OI和Cdyn较B组明显升高,RI明显降低(P<0.05);且A组患者在T3、T4时的OI和Cdyn较T1时明显增高,RI明显降低(P<0.05)。结论高渗氯化钠溶液能改善术中单肺通气患者的OI、RI及Cdyn,对肺功能有一定的保护作用。
Objective To observe the oxygenation index（OI）,respiratory index（RI） and dynamic lung compliance（Cdyn） changes of the patients with one-lung ventilation,in order to determine if hypertonic saline has lung protective effects.Methods Sixty ASA Ⅰ-Ⅲ patients who needed one-lung ventilation during thoracotomy under general anesthesia with double-lunmen endotracheal tubes were chosen to be the study subjects.No obvious abnormalities were detected by cardiopulmonary function screening,blood test,hepatorenal function and blood coagulation examinations in these patients.They were randomly divided into hypertonic saline group（group A） and control group（group B） with 30 patients in each group.For patients in group A,30 minutes after one-lung ventilation,infusion of 7.5% hypertonic saline solution at 2 mL/kg was carried out and completed in 15 minutes.For patients in group B,the same amount of saline solution was infused.We recorded OI,RI and Cdyn changes before the infusion（T1）,on the completion of the infusion（T2）,30 minutes after the infusion（T3）,and 1 hour after the infusion（T4）.The changes of vital signs in patients of the two groups were compared.Results OI,RI and Cdyn were not significant different between the two groups at T1 and T2（P〉0.05）.Mean arterial pressure（MAP）,heart rate（HR）,SpO2,central venous pressure（CVP）,and PetCO2 were not significant different between the two groups at all time points（P〉0.05）.OI and Cdyn of group A patients were significantly higher than those of group B,while RI was significantly lower at T3 and T4（P〈0.05）.Cdyn and OI of group A patients at T3 and T4 were significantly higher when compared with T1,and RI was significantly lower（P〈0.05）.Conclusion Hypertonic saline has the lung protection effect in patients with one-lung ventilation by improving OI,RI and Cdyn
出处
《华西医学》
CAS
2011年第8期1192-1194,共3页
West China Medical Journal
关键词
高渗氯化钠溶液
单肺通气
氧合指数
呼吸指数
肺顺应性
肺保护
Hypertonic saline
One-lung ventilation Oxygenation index
Respiratory index
Lung compliance
Lung protection
