单肺通气时不同潮气量对呼吸功能的影响

单肺通气时不同潮气量对呼吸功能的影响
侯彦深;姜莉莉;蒋晖
【期刊名称】《临床麻醉学杂志》
【年(卷),期】2012(28)2
【摘要】Objective To evaluate difference tidal volume during one lung ventilation (OLV). Methods Sixty ASA I or Ⅱ grade patients, scheduled for selective right thoracotomy under left lateral decubitus position were randomly divided into three groups with 20 each: A, B and C. After induction of anesthesia, two lung ventilation(TLV) was performed with Vt 10 ml/kg. Respiratory rate (RR) was 12 times pei minute (BPM)and ratio of inspiratory to expiratory (I: E) was 1! 2. During OLV I:E was keep steady, Vt was reduced to 6 ml/kg in group A, 8 ml/kg in group B, and lOm/kg in group C. Laboratory examination was determined before OLV(T1) and 10 min(T2) , 20 min(T3), 30 min (T4 ) after OLV. Qs/Qt and lung compliance (Cdyn) were calculated. Results Three group PaO2 and Cdyn decreased and PaCO2, Qs/Qt,Pmax, and Pmean increased from T2 to T4 when compared with T1. Paft deceased and Pmax, Pmean increased from T2 to T4 in group C when compared with group B. Group B had a good general evaluation in T4. Conclusion 8 ml/kg may be a good tidal volume during OLV.%目的研究单肺通气(OLV)时不同潮气量时的综合评价.方法60例右侧开胸左侧卧位非右肺全肺切除患者,ASA Ⅰ或Ⅱ级,随机分为A、B、C三组,每组20例.全麻后双肺通气(TLV)潮气量(VT)均为10 ml/kg,RR为12次/分,吸
呼比(I∶E)为1∶2.OLV期间A组VT6ml/kg,B组VT 8 ml/kg,C组VT10 ml/kg,分别于OLV前(T1)及OLV后10 min(T2)、20 min(T3)、30 min(T4)采集动脉血及中心静脉血行实验室检查,并计算肺内分流量(Qs/Qt),同时监测气道压力并计算动态肺顺应性(Cdyn),监测PETCO2,并在T4时对三组患者进行综合评价.结果与T1时比较,T2～T4时三组PaO2、Cdyn降低,PaCO2、Qs/Qt、Pmax、Pmean 明显升高(P＜0.05).与B组比较,T2～T4时C组PaO2降低,Pmax、Pmean明显升高(P＜0.05).T4时B组综合评价最好.结论 OLV期间采用B组VT8 ml/kg相对较好.
【总页数】3页(P143-145)
【作者】侯彦深;姜莉莉;蒋晖
【作者单位】830011 乌鲁木齐,新疆医科大学附属肿瘤医院麻醉科;830011 乌鲁木齐,新疆医科大学附属肿瘤医院麻醉科;830011 乌鲁木齐,新疆医科大学附属肿瘤医院麻醉科
【正文语种】中文
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