单肺通气与双肺通气在七氟醚吸入麻醉中麻醉深度的比较  

Comparison of Anesthetic Depth of Sevoflurane linhalation Anesthesia Between OLV and TLV

作　　者：王伟芝[1] 罗艳华[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院麻醉科,山东潍坊261041

出　　处：《潍坊医学院学报》2011年第5期359-361,I0003,共4页Acta Academiae Medicinae Weifang

摘　　要：目的 观察比较单肺通气（ OLV）和双肺通气（TLV）对七氟醚吸入麻醉过程中对麻醉深度的影响.方法 全身麻醉下行上消化道肿瘤切除术病人30例根据是否开胸分为OLV组和TLV组,分别于全麻诱导后插入双腔支气管导管或单腔气管导管行控制呼吸,并记录每组病人各个时点的脑电双频指数（ BIS）、七氟醚吸入气浓度（Fi）和呼出气浓度（Et）.结果 组间：OLV组BIS高于TLV组（P＜0.05）；OLV组Et高于TLV纽（P＜0.01）；OLV组Fi高于TLN组（P＜0.01）.组内：OLV组：BIS呈逐渐下降趋势,20min以后达到稳态；Et呈逐渐上升趋势,30min后达到稳态；Fi呈逐渐上升趋势30min后达到稳态.TLV组：BIS呈逐渐下降趋势,20min以后达到稳态,70 ～ 120min BIS低于40；Et呈逐渐上升趋势,20min后达到稳态；Fi呈逐渐上升趋势,20min后达到稳态.结论 设定吸入浓度为3％ vol,氧流量为2L/min的条件下,OLV与TLV均可达到满足手术要求的麻醉深度,但TLV组在70min后应调整吸入浓度以避免麻醉过深.与双肺通气相比,相同时点单肺通气麻醉深度较浅,达到稳定麻醉深度的时间较长（30min/20min）.Objective To compare anesthetic depth of sevoflurane inhalation anesthesia between one-lung ventilation and twolung ventilation. Methods Thirty patients undergoing upper gastrointestinal tumorectomy were divided into two groups according to opening chest or not：one-lung ventilation（OLV） and two-h, ng ventilation（TIN）. Double-lumen endobronchial tube or mon-lumen traeheal tube was inserted after general anesthesia for controlled ventilation. Bispectral Index（BIS） , Fi and Et were recorded at every marked time. Results BIS of OI,V group was higher than TLV group（ P 〈 0. 05 ）, Et of OLV group was higher than TIN group （ P 〈 0.01 ）, Fi of OIN group was higher than TLV group（ P 〈 0.01 ）. OI.V group：BlS generally decreased and got into steady state at 20 minute. Et generally increased and got into steady sizzle at 30 minute. Fi generally increased and go! inlo steady stale at 30 minule. TLV group：BIS generally decreased and got inlo sleadv stale al 20 minute,and BIS in 70 - 120 minnie was under 40. Et generally increased anti gol into steady state at 20 minule. Fi generally increased anti gol into steady slate at 20 minute. Conclusion With sevoflurane inhalanl concentration 3% vol, OI,V and TLV could supply surgery-needed anesthetic depth,and TLV group shouht adjust inhalant concentration to avoid excessive anesthesia. Anesthetic depth of OI,V was less than thai of TIN ,and the lime gelling into steady state was hmger Ihan that of TLV（30min/20min）

关 键 词：单肺通气 七氟醚 脑电双频指数 呼出气浓度 

分 类 号：R614.21[医药卫生—麻醉学]