摘要
目的采用肺超声评价PEEP对无高危因素患儿肺不张的影响。方法择期行非腹部手术患儿100例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄1~6岁,BMI在正常范围,采用随机数字表法分为无PEEP组(C组,n=50)和PEEP(P组,n=50)。静脉注射丙泊酚后即刻行容量控制通气,P组PEEP 5 cmH2O 、潮气量8 ml/kg,吸呼比1∶2,通气频率20-25次/min。C组不给予PEEP,余设置同P组。于麻醉诱导后和术毕时行肺部超声检查。记录肺不张严重程度和发生情况。结果与C组比较,P组麻醉诱导后和术毕时肺不张程度减轻,发生率降低(P<0.05)。结论对于无肺不张高危因素的患儿,早期应用PEEP 5 cmH2O可减少肺不张的发生。
Objective To evaluate the effect of positive end-expiratory pressure (PEEP) on lung atelectasis using lung ultrasound ( LUS) in the pediatric patients without high risk factors. Methods One hundred American Society of Anesthesiologists physical statusⅠor Ⅱ patients of both sexes, aged 1-6 yr, with body mass index in the normal range, scheduled for elective non-abdominal surgery, were divided into no PEEP group (group C, n=50) and PEEP group (group P, n=50) using a random number table meth-od. The animals were mechanically ventilated in volume-controlled mode after intravenously injecting propo-fol, with PEEP 5 cmH2 O, tidal volume 8 ml/kg, inspiratory/expiratory ratio 1 : 2, respiratory rate 20-25 breaths/min in group P. In group C, the animals received no PEEP, and the other treatments were similar to those previously described in group P . Lung ultrasound was carried out after anesthesia induction and at the end of surgery. The severity and development of lung atelectasis were recorded. Results Compared with group C, the severity of lung atelectasis was significantly reduced after anesthesia induction and at the end of surgery, and the incidence of lung atelectasis was decreased in group P ( P<0. 05). Conclusion Early application of PEEP 5 cmH2 O can reduce the occurrence of atelectasis for the pediatric patients with-out high risk factors for atelectasis.
作者
朱昌娥
章赛吉
董俊莉
魏嵘
Zhu Change;Zhang Saiji;Dong Junli;Wei Rong(Department of Anesthesiology,Shanghai Children′s Hospital Children′s Hospitol of Shanghai Jiao Tong University,Shanghai 200062,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2019年第6期669-672,共4页
Chinese Journal of Anesthesiology
关键词
儿童
肺不张
正压呼吸
Child
Pulmonary atelectasis
Positive-pressure respiration
