肺复张安全性观察  

The safety of recruitment maneuvers on elder patients after significant operation

作　　者：宁波[1] 李一粟[1] 马宇洁[1] 马建珍[1] 刘涛[1] 

机构地区：[1]空军总医院ICU,北京100036

出　　处：《空军总医院学报》2008年第1期17-18,共2页Journal of General Hospital of Air Force,PLA

摘　　要：目的研究肺复张（RM）的安全性，为肺复张在临床上进一步推广使用提供理论依据。方法2007年2月～2008年1月空军总医院重症监护科（ICU）收治的70岁以上老年患者20例，均为重大手术后，全麻手术持续6h以上，处于麻醉、肌松状态入ICU，均有有创动脉压监测。RM条件吸入氧浓度0．60，呼吸频率20次／min，潮气量5ml／kg，开放压25cmH2O，吸呼时间比1：2，持续30S，1h后重复一次。记录RM时心率、CVP、血压变化，记录RM前及末次RM后1h动脉血气分析，观察RM的不良反应。结果（1）RM对心率、血压有影响（P〈O．05），但未出现严重不良反应。（2）RM前后心率、血压变化不明显（P〉O．05）。（3）RM后氧合指数变化明显（P〈0．05）。结论RM在老年患者中使用较安全，并可明显改善老年人氧合指数。Objective Explore the safety of recruitment maneuvers on elder patients after significant operation. Methods Observe 20 cases of elder patients after significant operation in intensive care unit （ICU） of Beijing Air Force general Hospital. RMs were conducted by regulating FiOz to 0. 60, Vt was set at 5 ml/kg, applying 25 cm H2O of continuous positive end expiratory pressure（PEEP） for 30 seconds, and then resumed the previous ventilator setting. This modality was repeated once after 1 hour. Heart rate, mean arterial pressure, central venous pressure and PaOz/FiOz were measured before and after the RM. Results （1） Heart rate, blood pressure were significant change among RM, but no severe side effects were found during the treatment. （2）The change of heart rate, blood pressure recovered soon after RM. （3）PaO2/FiO2 increased after RM. Conclusion RM is safe. It could significant improve oxygenation.

关 键 词：肺不张 安全 

分 类 号：R563.4[医药卫生—呼吸系统]