摘要
目的观察对食管癌根治术患者低流量麻醉单肺通气对肺内分流的影响。方法择期行食管癌根治术患者50例,年龄在42～75岁,ASA分级Ⅰ或Ⅱ级,随机分为低流量组(A组)和常流量组(B组),每组25例。单肺通气时A组氧流量1.0 L·min-1,B组氧流量3.0 L·min-1,分别测定麻醉诱导后(T1)及单肺通气15 min(T2)、30 min(T3)、45 min(T4)、60 min(T5)及恢复双肺通气30 min(T6)时CVP、HR、MAP和气道平均压(Pmean),同时采集颈内静脉和桡动脉血样,进行血气分析,计算肺内分流率(Qs/Qt)。结果与T1时比较,两组T2～5时Pmean和Qs/Qt升高(P<0.05);两组间各时点Pmean、Qs/Qt、CVP、HR和MAP比较差异无统计学意义(P>0.05)。结论食管癌根治术患者低流量麻醉单肺通气对肺内分流无明显影响。
Objective To evaluate the effect of low volume anesthesia on intrapulmonary shunt during one-lung ventilation in patients un- dergoing esophageal cancer resection. Methods Fifty ASA I or Ⅱ patients of both sexes aged 42 ~ 75 yr undergoing esophageal cancer re- section were randomly divided into low volume anesthesia group （group A） and normal volume anesthesia group （group B） ,each group of 25 patients. In group A, oxygen supply was administered with 1.0 L · min^ - 1 during OLV, while in group B, oxygen supply was adminis- tered with 3.0 L · min ^-l during OLV. Left radial artery and right internal jugular vein were eannu]ated for MAP and CVP monitoring and blood sampling. MAP, HR, CVP, mean airway pressure were monitored and recorded after induction of anesthesia （ Tl ） , at 15,30 min ,45 min and 60 min of OLV （ T2,3,4,5 ） and 30 rain after re-expansion of the collapsed lung （ T6 ）. Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis. Intrapulmonary shunt （ Qs/Qt）was calculated. Results Mean airway pressure and Qs/Qt was significantly increased during OLV compared with two-lung ventilation （TLV） in two groups（ P 〈 0.05 ）. There was no significant difference in MAP, HR, CVP, mean airway pressure and Qs/Qt during one lung ventilation between the two groups. Conclu- sion Low volume anesthesia has no effect on hypoxic pulmonary vasoconstriction during one-lung ventilation in patients undergoing e- sophageal cancer resection.
出处
《安徽医药》
CAS
2012年第6期812-813,共2页
Anhui Medical and Pharmaceutical Journal
关键词
单肺通气
肺通气/血流比值
低流量
one-lung ventilation
pulmonary ventilation-perfusion ratio
low volume
