注射用碳酸酰胺过氧化氢在开胸单肺通气时的应用  

The application of carbonyl hydrogen peroxide during one lung ventilation in man

作　　者：刘晓江[1] 高光洁[1] 姚靖[1] 张铁铮[1] 王凤学[1] 

机构地区：[1]沈阳军区总医院麻醉科,110016

出　　处：《临床麻醉学杂志》2004年第6期325-326,共2页Journal of Clinical Anesthesiology

摘　　要：目的　探讨注射用碳酸酰胺过氧化氢 (碳胺氧 )对开胸单肺通气时低氧血症的防治效果。方法　 36例择期开胸行单肺通气患者 ,年龄 33～ 82岁 ,ASAⅠ～Ⅱ级 ,随机均分为对照组 (Ⅰ组 )和观察组 (Ⅱ组 ) ,单肺通气后以 5ml/min速度分别滴入 5 %葡萄糖液 30 0ml和溶入碳胺氧 1g的5 %葡萄糖液 30 0ml。术前及单肺通气后 2 0、4 0、6 0、80min各时点采动脉血行血气分析。结果　Ⅱ组与Ⅰ组相比 ,单肺通气且给予碳胺氧 2 0、4 0、6 0min时 ,PaO2 和SpO2 均显著升高 (P <0 0 1,P <0 0 5 ) ,pH和PaCO2 无显著性差异 (P >0 0 5 )。与术前相比 ,Ⅱ组单肺通气 4 0、6 0、80min时的PaO2和SpO2 均显著升高 (P <0 0 1,P <0 0 5 )。结论　开胸单肺通气时应用注射用碳酸酰胺过氧化氢 ,可作为防治低氧血症的有效措施之一。Objective To study the effect of carbonyl hydrogen peroxide in preventing and curing the hypoxemia during the period of one lung ventilation.Methods Thirty-six patients scheduled for thoracic surgery,aged 33-82, ASAⅠ-Ⅱ,served as the experimental subjects.Anesthesia was induced with propofol 2 mg/kg, fentanyl 2 μg/kg, and succinylcholine chloride 2 mg/kg.The patients were randomly divided into two groups.The patients in groupⅠwere given 300 ml 5% liquid glucose in a rate of 5 ml/min,and those in groupⅡ were given 1g carbonyl hydrogen peroxide that was dissolved in 300 ml 5% liquid glucose at the same rate.Arterial blood gases of all patients were monitored before operation and at 20, 40, 60 and 80 min after one lung ventilation.Results The PaO 2and SpO 2in groupⅡ were higherthan those in groupⅠ at 40, 60 and 80 min during one lung ventilation(P<0.01,P<0.05), but pH and PaCO 2were not significantly different. The PaO 2and SpO 2in groupⅡ 40, 60 and 80 min after lung ventilation were higher than those before operation(P<0.01,P<0.05).Conclusion Carbonyl hydrogen peroxide can effectively prevent and cure hypoxemia during the period of one lung ventilation in patients undergoing thoractomy.

关 键 词：注射用碳酸酰胺过氧化氢 开胸手术 单肺通气 低氧血症 预防 

分 类 号：R614[医药卫生—麻醉学]