不同吸入氧浓度对妇科腹腔镜手术患者肺顺应性及氧合的影响  

The influence of oxygen concentrations on lung compliance and oxygenation in patients undergoing gynecological laparoscopic surgery

作　　者：耿桂启[1] 李宁[1] 李泓[1] 黄绍强[1] 

机构地区：[1]复旦大学附属妇产科医院麻醉科,上海200090

出　　处：《复旦学报（医学版）》2012年第1期53-55,共3页Fudan University Journal of Medical Sciences

基　　金：上海市卫生局基金项目(2009030)~~

摘　　要：目的观察不同吸入氧浓度对妇科腹腔镜手术患者肺顺应性及肺内氧合的影响。方法选择全身麻醉下行妇科腹腔镜手术的患者50例,随机分为A、B两组,麻醉维持期间吸入氧浓度分别为50%(A组)或100%(B组);分别于气腹前、气腹后1min和气腹放气后1min记录气道峰值压力、肺顺应性及呼气末二氧化碳分压等参数,并在麻醉前以及气腹放气后1min采取桡动脉血进行血气分析并计算氧合指数及肺内分流率(Qs/Qt)。结果在二氧化碳气腹后,两组患者肺顺应性明显降低(P<0.01)。气腹放气后,两组患者肺顺应性较气腹后明显增加,同B组相比,A组患者肺顺应性增加更为明显(P<0.05);两组患者氧合指数间差异无统计学意义,B组患者Qs/Qt明显高于A组(P<0.01)。结论麻醉维持期间吸入50%氧较纯氧通气更有利于腹腔镜手术患者肺功能的恢复。Objective To evaluate the effects of different oxygen concentrations on lung compliance and arterial oxygenation in patients undergoing gynecological laparoscopic surgery. Methods Fifty female patients undergoing gynecological laparoscopic surgery,ASAⅠ-Ⅱ,were randomly allocated to receive either 50%（A group） or 100%（B group） oxygen concentrations during general anesthesia.Premedication,general anesthesia and ventilation patterns were standardized.Airway peak pressure,lung compliance and end-tidal partial pressure of carbon dioxide（PETCO2） were evaluated before pneumoperitoneum,1 minute after pneumoperitoneum and 1 minute after deflation.Arterial blood gas analysis was carried out to measure PaO2 and PaCO2 before anesthesia induction and 1 minute after deflation. Results The values of lung compliance were significantly increased in two groups after pneumoperitoneum,compared with that before pneumoperitoneum（P0.01）.In group A,the value of lung compliance was increased more significantly after deflation（P0.05）.The difference in oxygenation index between two groups was not significant.The value of Qs/Qt in group B was larger than that in group A（P0.01）. Conclusions Mechanical ventilation with 50% oxygen concentration is more profitable in preserving postoperative lung function in patients undergoing gynecological laparoscopic surgery.

关 键 词：肺顺应性 氧合 腹腔镜手术 

分 类 号：R614.2[医药卫生—麻醉学]