摘要
目的探索压力控制容量保证通气(PCV-VG)模式对老年胰腺癌患者术中肺通气的影响。方法选取2022年6月至2023年4月于南京医科大学第一附属医院全麻下行胰腺十二指肠切除术的老年胰腺癌患者68例作为研究对象,其中V组34例术中接受容量控制通气(VCV)模式,P组34例术中接受PCV-VG通气模式。于患者入手术室(T0),麻醉诱导气管插管后5 min(T1),手术开始30 min(T2),手术开始90 min(T3),手术结束(T4)5个时间点监测并记录患者的心率(HR),平均动脉压(MAP)。记录T1~T4时间点患者的气道峰压(P_(peak))、气道平均压(P_(mean))、动态肺顺应性(Cdyn)、潮气量(VT)。采集T0~T4动脉血进行血气分析并记录动脉血氧分压(PaO_(2))及动脉血二氧化碳分压(PaCO_(2))。结果PCV-VG组在各时间点的P_(peak)均低于VCV组(P<0.05),Cdyn均高于VCV组(P<0.05)。两组在各时间点的PaO_(2)、PaCO_(2)、HR和MAP差异无统计学意义(P>0.05)。结论在老年胰腺癌患者胰腺十二指肠切除术中,与VCV模式比较,PCV-VG模式能够有效降低气道压力,改善肺顺应性,促进气体交换,对呼吸功能的影响较小。
Objective To explore the effect of pressure-controlled ventilation-volume guaranteed(PCV-VG)on lung ventilation in elderly patients with pancreatic cancer during operation.Methods A total of 68 elderly patients who underwent elective pancreaticoduodenectomy at The First Affiliated Hospital of Nanjing Medical University from June 2022 to April 2023 were selected as the study subjects.Among them,the V group consisted of 34 patients who received volume-controlled ventilation(VCV)during surgery.The P group consisted of 34 patients who received PCV-VG during surgery.Heart rate(HR)and mean arterial pressure(MAP)of patients were monitored and recorded at five time points:admission(T0),5 minutes after tracheal intubation(T1),30 minutes after surgery(T2),90 minutes after surgery(T3),and end of surgery(T4).The peak airway pressure(P_(peak)),mean airway pressure(P_(mean)),dynamic lung compliance(Cdyn),and tidal volume(VT)of T1-T4 were recorded.T0-T4 arterial blood was collected for blood gas analysis,and PaO_(2)and PaCO_(2)were recorded.Results The P_(peak)of the P group was lower than that of the V group at all time points(P<0.05),and the Cdyn was higher than that of the V group(P<0.05).There was no significant difference in PaO_(2),PaCO_(2),HR and MAP between the two groups at each time point(P>0.05).Conclusion Compared with VCV mode,PCV-VG mode can effectively reduce airway pressure,improve lung compliance,promote gas exchange,and have less impact on respiratory function in elderly patients undergoing pancreaticoduodenectomy.
作者
陈盼盼
马禾
陈自洋
CHEN Panpan;MA He;CHEN Ziyang(Department of Anesthesiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)
出处
《中国临床研究》
CAS
2023年第12期1857-1860,1865,共5页
Chinese Journal of Clinical Research
基金
国家自然科学基金(82102261)
南京医科大学第一附属医院青年基金培育计划(PY2021004)。
关键词
压力控制容量保证通气
容量控制通气
胰腺癌
胰腺十二指肠切除术
老年
肺通气
肺顺应性
Pressure-controlled ventilation-volume guaranteed
Volume-contolled ventilation
Pancreatic cancer
Pancreaticoduodenectomy
Elderly patients
Respiratory function
Dynamic lung compliance
