七氟醚-安氟醚对犬单肺通气期间肺分流与氧供及氧耗的影响  

Effects of sevoflurane,enflurane on oxygen delivery,consumption and pulmonary shunt during one-lung ventilation in dogs

作　　者：马宁[1] 李树人[1] 王芳[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,100050

出　　处：《中国急救医学》2000年第1期4-7,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的　观察犬单肺通气时,不同浓度七氟醚、安氟醚对Qs/Qt和氧供及氧耗等氧合指标的影响。方法　14只健康杂种犬,诱导后插入双腔气管内导管,股动静脉分别置管监测血气和各自压力。随机分为两组,A组顺序吸入05MAC、10MAC安氟醚,待完全排除后再顺序吸入七氟醚;B组反之。各时相均分为双肺通气(TLV)和单肺通气(OLV)阶段,分别于TLV、OLV15分钟后测量Qs/Qt及氧供(DO2)、氧耗(VO2)等各指标变化。实验结果以Cross-over对照法进行分析。结果　A、B两组间相同药物不同时机吸入时结果相近。两药对体、肺循环抑制程度随吸入浓度增高而加大,氧分压(PaO2)、DO2剂量依赖性降低(P<005),氧摄取率(ERO2)增加,但两药均未出现DO2-VO2依赖及无氧代谢征象。OLV时Qs/Qt均较TLV时增加(P<001),且吸入浓度增高时更显著(P<005);Qs/Qt于TLV时两药间无差异(P>005),但OLV时安氟醚较为明显(P<001)。结论　两药均可安全用于OLV,且七氟醚优于安氟醚。Objective To evaluate the effects of sevoflurane,enflurane on oxygen delivery,consumption and pulmonary shunt during one-lung ventilation in dogs.Methods Fourteen healthy dogs were used in this study.Following induction and double lumen endotracheal tubes placement,Various catheters were inserted into bilateral femoral arteries and veins for pressures and blood gases monitoring.All subjects were divided into two groups randomly.In group A,0 5,1 0 MAC enflurane(ENF) were given in turn firstly,then this course was repeated with sevoflurane(SEVO) after former drug had been fully eliminated;In group B,the sequence was exactly opposite.Each phase was subdivided into two ones:two-lung ventilation(TLV) and one-lung ventilation(OLV).In every phase,indexes were measured 15 minutes after TLV and OLV,respectively.All data were analyzed according to Cross-Over design rule.Results The results between A and B groups were similar when the same drug was inhaled at different time.Accompanied with the increase of inhaled concentration,systemic and pulmonary circulation indexes were depressed similarly in dose-dependent way by these two drugs.Both PaO 2 and oxygen delivery(DO 2) decreased gradually,oxygen extraction ratio(ERO 2) increased,but there was no signs of DO 2/VO 2 and anaerobic metabolism.Pulmonary shunt(Qs/Qt) showed a dose-dependent increase during TLV and OLV,the values during OLV were greater than TLV( P <0 01);though having no difference during TLV between two inhaled drugs( P <0 05),Qs/Qt was found higher when ENF was received than SEVO did at two concentration during OLV( P <0 01).Conclusion ENF and SEVO can be safely used during OLV at clinical concentration,and SEVO is more superior. [

关 键 词：单肺通气 脾分流 氧供 氧耗 麻醉 麻醉药 

分 类 号：R971.2[医药卫生—药品]