摘要
目的探讨低潮气量联合低呼气末正压通气在卵巢囊肿腹腔镜手术中的应用价值。方法选择2017年1月—2021年10月在本院接受腹腔镜手术治疗的60例卵巢囊肿患者作为研究对象,采用随机数表法分为研究组(接受低潮气量联合低PEEP通气)和对照组(接受传统潮气量联合传统PEEP通气)两组,每组各30例。对比两组患者麻醉诱导前(T0)、通气30分钟(T1)、拔管前(T3)的混合静脉血氧饱和度(SvO_(2))、心率、气道阻力(Raw)、收缩压(SBP)、气道吸气峰压(APIP)、平均动脉压(MAP)、静态肺顺应性(Cst);手术前后的颈内静脉血氧饱和度(SjvO_(2))、颅内压(ICP)、简易精神状态评价量表(MMSE)、脑动脉静脉血氧含量差(Da-jvO_(2))。结果T0时,两组的MMSE、MAP、APIP、Raw、Cst水平差异无统计学意义(P>0.05);T1时,研究组的MAP、Cst水平高于对照组(P<0.05),APIP、Raw水平低于对照组(P<0.05);T2时,研究组的心率、SBP、MAP、SvO_(2)、Cst高于对照组(P<0.05),APIP、Raw水平低于对照组(P<0.05)。术前,两组的ICP、SjvO_(2)、Da-jvO_(2)、MMSE差异无统计学意义(P>0.05);术后研究组的ICP、Da-jvO_(2)水平低于对照组(P<0.05),MMSE(t=3.947)评分高于对照组(P<0.05)。结论低潮气量联合低水平PEEP可提高卵巢囊肿腹腔镜手术患者肺顺应性,改善患者呼吸功能,降低机械通气对患者颅内压的影响。
Objective To investigate the value of low tidal volume combined with low positive end expiratory pressure ventilation in laparoscopic surgery for ovarian cyst.Methods 60 patients suffered with ovarian cysts,who underwent laparoscopic surgery in our hospital from January 2017 to October 2021,were randomly divided into the study group(30 cases,receiving low tidal volume combined with low PEEP ventilation)and the control group(30 cases,receiving traditional tidal volume combined with traditional PEEP ventilation).The mixed venous oxygen saturation(SvO_(2)),heart rate,airway resistance(Raw),systolic blood pressure(SBP),peak airway inspiratory pressure(APIP),mean arterial pressure(MAP)and static pulmonary compliance(CST)at the time points before anesthesia induction(T0),ventilation for 30 minutes(T1)and extubation(T3)were were compared between two groups.As well as the internal jugular vein oxygen saturation(SjvO_(2)),intracranial pressure(ICP),mini mental state evaluation scale(MMSE),cerebral artery venous oxygen content difference(Da-jvO_(2))before and after operation.Results At T0,there were no significant difference in the levels of MMSE,MAP,APIP,Raw and Cst between the two groups(P>0.05).At T1,the levels of MAP and Cst in the study group were higher than those in the control group(P<0.05),and the levels of APIP and Raw were lower than those in the control group(P<0.05).At T2,the heart rate,SBP,MAP,SvO_(2)and Cst of the study group were higher than those of the control group(P<0.05),and the levels of APIP and Raw were lower than those of the control group(P<0.05).Before operation,there were no significant difference in ICP,SjvO_(2),Da-jvO_(2)and MMSE between the two groups(P>0.05).After operation,the levels of ICP and Da-jvO_(2)in the study group were lower than those in the control group(P<0.05),and the score of MMSE(t=3.947)was higher than that in the control group(P<0.05).Conclusions Low tidal volume combined with low-level PEEP could improve lung compliance,improve respiratory function and reduce the effect of mechanical ventilation on intracranial pressure in patients with ovarian cyst undergoing laparoscopic surgery.
作者
陈梓航
徐俊
黄苑雯
Chen Zihang;Xu Jun;Huang Yuanwen(Department of anesthesiology,Chaozhou maternal and child health hospital,Chaozhou,Guangdong,521000,China)
出处
《齐齐哈尔医学院学报》
2022年第6期523-527,共5页
Journal of Qiqihar Medical University
关键词
卵巢囊肿
低潮气量
腹腔镜手术
呼气末正压通气
颅内压
Ovarian cyst
Low tidal volume
Laparoscopic surgery
Positive end expiratory pressure ventilation
Intracranial pressure
