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低潮气量单肺通气复合呼气末正压对开胸患者免疫功能的影响 被引量:4

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摘要 目的观察低潮气量单肺通气复合呼气末正压对开胸术患者免疫功能的影响。方法选择ASAⅠ~Ⅱ级择期行开胸手术的病人30例,全麻后插入双腔支气管导管,侧卧位后,行双肺通气,待开胸后行单肺通气。所有病例按单肺通气模式不同分为3组:C组:传统单肺通气;P1组:低潮气量单肺通气复合呼气末正压通气;P2组:单肺通气时。每组均在相同时间点记录呼吸力学参数、血流动力学指标,并作血气分析,检测血浆IL-6、IL-8、IL-10的表达,观察T淋巴细胞亚群以及免疫球蛋白的变化。结果单肺通气时P1、P2两组与C组相比:气道峰压(Ppeak)明显下降(P<0.01),PaCO2升高(P<0.05),PaO2升高(P<0.05),MAP、HR无显著差异;血浆IL-6和IL-8释放减少,IL-10释放增多;与C组相比P1、P2两组免疫功能抑制减弱。结论低潮气量单肺通气复合呼气末正压通气可改善单肺通气氧合、降低气道压、减少炎症反应以及免疫抑制引起的肺损伤。
出处 《浙江创伤外科》 2011年第5期688-690,共3页 Zhejiang Journal of Traumatic Surgery
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