腹腔镜手术中压力和容量控制通气对患者气道峰压及肺氧合功能的影响  

The Effect of Laparoscopic Surgery about Pressure and Volume Control Ventilation in Patients with Peak Airway Pressure and Lung Oxygenation

作　　者：叶允荣[1] 杨明华[1] 

机构地区：[1]福建省肿瘤医院麻醉科,福建福州350014

出　　处：《中国医药指南》2012年第11期75-75,F0003,共2页Guide of China Medicine

摘　　要：目的分析腹腔镜手术中压力和容量控制通气对患者气道峰压及肺氧合功能的影响。方法选择ASA1～2级宫颈癌根治术患者40例,随机分成两组,容量控制通气(VCV)组,压力控制通气(PCV)组,每组20例,麻醉方法均为气管插管后接麻醉机行机械通气,分别于气管插管后气腹前(T1)、气腹后30min(T2)、气腹后60min(T3),监测气道峰压(Ppeak)的情况,抽取动脉血监测动脉二氧化碳分压(PaCO2)、动脉氧分压(PaO2),并计算氧合指数进行统计学分析。结果与T1时相比,两组Ppeak气腹后升高(P<0.05),容量控制通气(VCV)组更明显,而动脉二氧化碳分压(PaCO2)、动脉氧分压(PaO2)、氧合指数的变化无显著性差异。结论行腹腔镜手术时,压力控制通气可以有效降低术中气道压,防止气道损伤,同时不影响患者的氧合情况。Objective To analyze the pressure and volume controlled ventilation in patients with peak airway pressure and lung oxygenation function of laparoscopic surgery.Method To select ASA1 ~ Level 2 of cervical cancer radical surgery 40 patients were randomly divided into two groups,volumecontrolled ventilation（VCV） group,pressure control ventilation（PCV） group（n=20cases）,followed by anesthesia are tracheal intubation anesthesia machine mechanical ventilation,respectively pneumoperitoneum after intubation（T1）,pneumoperitoneum 30min after（T2） 60 min after pneumoperitoneum（T3）,monitoring airway peak pressure（Ppeak）,arterial blood was collected monitoring arterial carbon dioxide partial pressure（PaCO2 was）,arterial partial pressure of oxygen（PaO2）,and calculated the oxygenation index were statistically analyzed.Results Compared with T1,the two groups the Ppeak pneumoperitoneum increased（P 0.05）,volume controlled ventilation（VCV） group,the arterial carbon dioxide partial pressure（PaCO2）,arterial partial pressure of oxygen（PaO2）,oxygenation no significant difference in changes in the index.Conclusion Laparoscopic surgery,the pressure-controlled ventilation can effectively reduce intraoperative airway pressure to prevent the damage of the airway,while not affecting the patient＇s oxygenation.

关 键 词：腹腔镜 压力控制通气 容量控制通气 气道峰压 氧合指数 

分 类 号：R656[医药卫生—外科学]