单肺通气时不同潮气量对呼吸功能的影响  

General evaluation of difference tidal volume during one lung ventilation

作　　者：侯彦深[1] 姜莉莉[1] 蒋晖[1] 

机构地区：[1]新疆医科大学附属肿瘤医院麻醉科,乌鲁木齐830011

出　　处：《临床麻醉学杂志》2012年第2期143-145,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究单肺通气(OLV)时不同潮气量时的综合评价。方法 60例右侧开胸左侧卧位非右肺全肺切除患者,ASAⅠ或Ⅱ级,随机分为A、B、C三组,每组20例。全麻后双肺通气(TLV)潮气量(VT)均为10ml/kg,RR为12次/分,吸呼比(I∶E)为1∶2。OLV期间A组VT6ml/kg,B组VT8ml/kg,C组VT10ml/kg,分别于OLV前(T1)及OLV后10min(T2)、20min(T3)、30min(T4)采集动脉血及中心静脉血行实验室检查,并计算肺内分流量(Qs/Qt),同时监测气道压力并计算动态肺顺应性(Cdyn),监测PETCO2,并在T4时对三组患者进行综合评价。结果与T1时比较,T2～T4时三组PaO2、Cdyn降低,PaCO2、Qs/Qt、Pmax、Pmean明显升高(P<0.05)。与B组比较,T2～T4时C组PaO2降低,Pmax、Pmean明显升高(P<0.05)。T4时B组综合评价最好。结论 OLV期间采用B组VT8ml/kg相对较好。Objective To evaluate difference tidal volume during one lung ventilation（OLV）. Methods Sixty ASA I or II grade patients, scheduled for selective right thoracotomy under left lateral decubitus position were randomly divided into three groups with 20 each： A, B and （2. After induction of anesthesia, two lung ventilation（TLV） was performed with VT 10 ml/kg. Respiratory rate （RR） was 12 times per minute （BPM）and ratio of inspiratory to expiratory （I： E） was 1：2. During OLV I： E was keep steady, VT was reduced to 6 ml/kg in group A, 8 ml/kg in group B, and 10m/kg in group C. Laboratory examination was determined before OLV（T1 ） and 10 min（T2）, 20 rain（T3 ）, 30 rain （T4） after OLV. Qs/Qt and lung compliance （Cdyn） were calculated. Results Three group PaO2 and Cdyn decreased and PaCO2, Qs/Qt, Pmax, and Pmean increased from T2 to T4 when compared with T1. PaO2 deceased and Pmax, Pmean increased from T2 to T4 in group C when compared with group 13. Group t3 had a good general evaluation in T4. Conclusion 8 ml/kg may be a good tidal volume during OLV.

关 键 词：单肺通气 综合评价 肺内分流 潮气量 

分 类 号：R614[医药卫生—麻醉学]