减少非通气侧肺血流在单肺通气期间对肺内分流和血气的影响  

The evaluate the effects of reduce the flow of non - ventilated lung for one lung ventilation（OLV） on intrapulmonary shunt（ Qs/ Qt） and blood gas

作　　者：刘文粤 李长科[1] 万震威[1] 

机构地区：[1]韶关市粤北人民医院麻醉科,广东韶关512026

出　　处：《中外医学研究》2010年第17期16-17,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的 观察减少非通气侧肺血流在单肺通气期间对肺内分流和血气的影响.方法 15例择期胸科手术患者,ASAⅠ～Ⅱ级,术中采取部分阻断非通气侧肺动脉的方法减少非通气侧肺血流,使肺动脉压（PA）不超过30 mmHg为宜.分别在单肺通气前1 min（T1）,单肺通气后阻断前1 min（T2）、阻断后30 min（T3）、开放前1 min（T4）各时刻抽取动脉血和混合静脉血行血气分析,并根据血气分析结果计算肺内分流率（Qs/Qt）.结果 T2时刻肺内分流率较T1时刻显著增加,动脉血氧分压较T1时刻显著下降.T3、T4时刻肺内分流率较T2显著降低,接近T1时刻.动脉血氧分压较T2明显回升.结论 减少非通气侧肺血流在单肺通气期间可减少肺内分流,明显改善动脉血氧.Objective To evaluate the effects of reduce the flow of non - ventilated lung for one lung ventilation （OLV） on intrapulmonary shunt（Qs/Qt） and blood gas. Methods 15 ASA Ⅰ- Ⅱpatients were selected in the study. Surgery to partially block the way of non - ventilated pulmonary to reduce the flow of non - ventilated lung. To pulmonary artery pressure （PA） is appropriate not more than 30 mmHg. Arterial blood and mixed venous blood were taken for blood gas analysis 1 minute before OLV （T1）, after OLV and 1 minutes before block （T2）, 30 minutes after block（ T3 ）, and 1 min before open（ T4 ）. Qs/Qt was calculated. Results T2 time intrapulmonary shunt fraction increased significantly compared with T1 time, Arterial oxygen partial pressure decreased significantly compared with T1 time. T3 ,T4 time left shunt was significantly lower than T2, close to the T1 time. Arterial oxygen partial pressure in rebounded T2. Conclusion Reduce the flow of non - ventilated lung during one -lung ventilation can reduce the pulmonary shunt, significant improvement in arterial oxygen.

关 键 词：减少非通气侧肺血流 单肺通气 肺内分流 血气 

分 类 号：R614[医药卫生—麻醉学]