低潮气量机械通气对肺功能正常心脏手术患者的影响  

The influence of ventilation with low tidal volume on the patients with normal respiratory function undergoing cardiac surgery

作　　者：陈宇[1] 

机构地区：[1]南京医科大学第一附属医院麻醉科,210029

出　　处：《江苏医药》2011年第21期2538-2540,共3页Jiangsu Medical Journal

摘　　要：目的比较低潮气量(LVT)机械通气与常规潮气量(CVT)机械通气对肺功能正常心脏手术患者的气管拔管的时间及预后影响。方法 72例行心脏瓣膜手术的患者随机均分为L组(VT6ml/kg)和C组(VT10ml/kg);调节通气频率(RR),保持呼气末二氧化碳分压(PETCO2)35～45mm Hg。比较两组患者的气管拔管时间、呼吸参数、血气分析及血浆IL-6表达。结果 L组RR快于C组,入ICU 10min后的PETCO2明显低于C组;术后在ICU期间的IL-6浓度明显低于C组(P<0.05)。两组平均气管拔管时间相仿(P>0.05);L组6h内气管拔管病例的比例明显高于C组(17.3%vs.25%)(P<0.05),L组患者需二次插管率明显低于C组(2.7%vs.14.3%)(P<0.05)。结论 LVT也适用于肺功能正常心脏手术患者的CVT机械通气;且与CVT机械通气比较,LVT机械通气患者拔管早,需再次插管的少。Objective To compare the influence of mechanical ventilation with low tidal volume（LVT） and conventional tidal volume（CVT） on the patients with normal respiratory function undergoing cardiac surgery.Methods A total of 72 patients with normal respiratory function undergoing cardiac surgery was equally randomized into two groups of L（VT 6 ml/kg） and C（VT 10 ml/kg）.PETCO2 35-45 mm Hg was kept by regulaing RR.The time of extubation,the percentage of patients extubated within 6 hours,blood gas analysis and plasma IL-6 expression were compared between two groups.Results The RR was higher in group L than that in group C.The plasma IL-6 expression during ICU stay and PETCO2 at 10 min after entering ICU were lower in group L than those in group C（P〈0.05）.The average time of extubation was similar for two groups（P〈0.05）.The percentage of patients extubated within 6 hours was significantly higher in group L than that in group C（17.3% vs.25%）（P〈0.05）.The reintubation rate was lower in group L than that in group C（2.7% vs.14.3%）（P〈0.05）.Conclusion LVT mechanical ventilation is suitable for the patients with normal respiratory function undergoing cardiac surgery with the advantages of earlier extubation and less need for reintubation.

关 键 词：机械通气 潮气量 

分 类 号：R614[医药卫生—麻醉学]