胸科手术中不同单肺通气模式对呼吸力学及氧合的影响  

Effect of different one-lung ventilation modes on the respiratory mechanics and oxygenation

作　　者：高昌达[1] 潘志浩[1] 郭建荣[1] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315040

出　　处：《现代实用医学》2009年第1期31-33,共3页Modern Practical Medicine

摘　　要：目的观察胸科手术中不同单肺通气模式对呼吸力学及全身氧合的影响。方法将80例择期行胸外科手术患者分为双腔支气管导管组(A组,40例)和Coopdech封堵支气管导管组(B组,40例)。麻醉诱导后分别插入单腔气管导管或双腔气管导管,B组将封堵支气管导管通过普通气管导管放置于手术侧主支气管,两组导管位置均经纤维支气管镜证实并定位。术中观察双肺通气时(TLV)、单肺通气后30min(OLV30)和60min(OLV60)患者的气道阻力(PAW)和血气指标的变化。结果B组插管时间和定位时间均小于A组(<0.01);在TLV、OLV30和OLV60B组PAw明显低于A组(<0.05)。两组血气指标PaO2、PaCO2、SaO2等差异无显著性(>0.05)。结论Coopdech封堵式支气管导管用于单肺通气胸外科手术具有插管和定位方便,损伤小,分隔双肺完全,对患者生理干扰小等优点。Objective To observe the impact of different one-lung ventilation methods on the respiratory mechanics and oxygenation. Methods 80 patients undergoing thoracic surgery were randomly allocated into endotracheal blocker group （n=40） and double lumen tube group （n=40）. After induction, the patients were intubated either by endotracheal tube or double-lumen tube respectively. Endotracheal blocker advanced into proper bronchial through endotracheal tube. Appropriate positions of tubes were confirmed by fiberoscopy. Airway pressure was observed, and blood gas analysis was performed at two-lung ventilation, 30 min and 60 min after one- lung ventilation respectively. Results Endotracheal blocker intubation could be completed in less time when compared with double-lumen tube. Airway pressure was significantly lower in endotracheal blocker group during the whole study period. No significant differences were found when blood gas parameters were compared between two groups（P〉0.05）, such as PaO2, PaCO2, SO2 and so on. Conclusion Coopdech endotracheal blocker can be used in one lung ventilation.

关 键 词：胸外科手术 肺通气 呼吸力学 

分 类 号：R655.3[医药卫生—外科学]