多巴酚丁胺增加心输出量对单肺通气时动脉氧合的影响  

Effects of increase of cardiac output by dobutamine on arterial oxygenation during one-lung ventilation

作　　者：毕严斌[1] 班艳林[1] 赵蔚[1] 王月兰[1] 

机构地区：[1]山东大学附属千佛山医院麻醉科济,南市250014

出　　处：《临床麻醉学杂志》2010年第9期748-749,共2页Journal of Clinical Anesthesiology

摘　　要：目的探讨小剂量多巴酚丁胺提高心输出量对单肺通气时动脉氧合的影响。方法 20例择期食管手术患者,麻醉后插入37F左侧双腔支气管导管。潮气量8ml/kg,呼吸频率12次/分,吸入氧浓度100%,单、双肺通气时呼吸参数不变。麻醉平稳后,患者于平卧位行左侧单肺通气15min(T1)、之后静注多巴酚丁胺2μg·kg-1.min-115min(T2)分别监测PaO2、PaCO2、pH值。同时记录SBP、DBP、HR、心脏指数(CI)。结果与T1时比较,T2时SBP、CI明显升高、HR明显增快(P<0.01)。T2时PaO2明显升高(P<0.01)。PaCO2、pH值差异无统计学意义。结论小剂量多巴酚丁胺提高心输出量可明显改善单肺通气时动脉氧合。Objective To study the effects of low dose dobutamine-induced cardiac output on arterial oxygenation during one-lung ventilation （OLV）. Methods Twenty patients undergoing thoracic operation were intubated with left 37 F double lumen bronchial tube after anesthesia induction and vetilated with a tidal volumen of 8 ml/kg resporation rate of 12 breath/min and 100% oxygen during one-lung or two-lung ventilation. With patients in supine position, at 15 min after OVL（T1 ）, dobutamine 2μg·kg-1·min-1 was administered for 15 rain （T2）, PaO2,PaCO2, pH were recorded, SBP,DBP, HR and cardiac index（CI） were recorded simultaneously. Results SBP, HR and CI increased significantly at T2 compared with those at T1 （P〈0.01）. PaO2 improved significantly at T2 compared with that at T1 （P % 0.01）, while PaCO2 and pH were not changed significantly. Conclusion The increase of cardiac output by small dosage of dobutamine can effectively improve arterial oxygenation during OVL.

关 键 词：多巴酚丁胺 单肺通气 动脉氧合 

分 类 号：R614[医药卫生—麻醉学]