摘要
目的探讨单肺通气模式下不同水平呼气末正压通气(PEEP)对肺损伤的影响。方法选择拟单肺通气剖胸手术患者60例,随机分成三组,每组20例。A组单肺通气6 mL/kg+PEEP为0 cmH2O,B组单肺通气6mL/kg+PEEP为4 cmH2O,C组单肺通气6 mL/kg+PEEP为8 cmH2O,术中均为持续性单肺通气,并排除肺功能差或有肺部疾病者。通过监测单肺通气前(T1)、单肺通气30 min(T2)、单肺通气60 min(T3)、单肺通气90 min(T4)、单肺通气结束前(T5)、出室前(T6)的SpO2、MAP、HR。采集颈内静脉血5 mL进行肿瘤坏死因子(TNF-α)、IL-6检测。结果三组治疗不同时间点MAP、HR、SpO2无统计学差异(P均>0.05)。B、C两组从T3开始相对于A组炎性因子水平较低且有统计学差异(P均<0.05),而B、C两组间炎性因子水平比较无统计学差异(P均>0.05)。结论单肺通气6 mL/kg+PEEP 4 cmH2O对肺损伤影响最小。
Objective To investigate the influence of different PEEP level on lung injury. Methods Sixty patients with esophageal cancer were randomly divided into three groups of A, B and C, 20 cases in each group. A group： one lung ventilation with tidal volume 6 mL/kg ＋ 0 cmH20 PEEP; B group： one lung ventilation with tidal volume 6 mL/kg ＋ 4 cmH20 PEEP; C group： one lung ventilation with tidal volume 6 ml/kg ＋ 8 cmH：O PEEP. In all the patients there were continual one lungventilation until the end of operation, Precluding patients with the bad lung function or lung disease, be- fore one-lung ventilation （ T1 ）, 30 min following OLV （ T2）, 60 min following OLV （ T3 ）, 90 min following OLV （ T4）, the end of the OLV （TS）, end of operation（T6）, the MAP, HR, SpO2 were detected, meanwhile collecting 5 mL blood from verty to determin the TNF-α and IL-6 level. Results There was no significant difference of MAP, HR, SpO2 at dif- ferent time point among the three goups. Inflammatory factors in B, C group were lower than those in A group（P 〈 0.05）, but there was no difference between B and C group. Conclusion One-lung ventilation with tidal volume 6 mIZkg ＋ 4 cmH20 PEEP do the lowest harm to lung.
出处
《山东医药》
CAS
2012年第41期26-28,共3页
Shandong Medical Journal
基金
河北省科技厅课题(10276171)
关键词
肺损伤
单肺通气
呼气末正压通气
lung injury
onelung ventilation
positive end expiratory pressure
