肺保护性通气对单肺通气患者肺功能及炎性因子的影响被引量：11

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摘要目的观察肺保护性通气对单肺通气(OLV)患者肺功能及炎性因子的影响。方法 55例择期行食管癌根治术治疗的患者随机分为A组(传统单肺通气组,n=27例)和B组(保护性单肺通气组,n=28例)。分别在双肺通气30min(T1)、单肺通气60 min(T2)和气管拔管后2h(T3)时记录气道峰压(Ppeak)、气道阻力(Raw)、胸肺顺应性(CT)等呼吸动力学指标,并在各时点检测动脉氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)等动脉血气指标,采用酶联免疫吸附(ELISA)法检测炎性细胞因子(IL-6、IL-8)表达水平。结果两组在T2、T3时PaO_2较T1时明显降低(P<0.05),且A组降低较B组更为显著(P<0.05),A组T2、T3时PaCO_2较T1时和B组同时间点均明显升高(P<0.05);两组T2时CT较T1时明显降低(P<0.05),而Ppeak、Raw明显升高,且A组升高或降低较B组更为显著(P<0.05);两组T2、T3时IL-6、IL-8表达水平较T1时明显升高,且A组升高较B组更为显著(P<0.05)。结论采用肺保护性通气策略可显著降低单肺通气时气道压力及阻力,增加胸肺顺应性,减少OLV期间及术后炎性细胞因子的释放,从而明显减轻肺组织的炎性反应程度。

作者屈昕

机构地区荆州市中医医院麻醉科

出处《临床肺科杂志》 2017年第2期364-366,共3页 Journal of Clinical Pulmonary Medicine

关键词肺保护性通气策略单肺通气炎性因子肺功能患者动脉二氧化碳分压炎性细胞因子胸肺顺应性

分类号 R614 [医药卫生—麻醉学] R735.1 [医药卫生—肿瘤]

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1李风茹,丁洁,申六女,高景,耿恩江.保护性单肺通气在老年患者开胸手术中的应用[J].河北医药,2009,31(22):3050-3052. 被引量：9
2苏瑞雪,李玉兰,潘道刚,张杨.单肺通气中肺损伤及肺复张策略[J].临床肺科杂志,2015,20(10):1876-1879. 被引量：13

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