小潮气量机械通气应用于腹腔镜胆囊切除术的临床观察  

Clinical application of mechanical ventilation with low tidal volume in laparoscopic cholecystectomy

作　　者：仲华[1] 杨国生[1] 陈宏莲[1] 王强[2] 罗天仁[1] 马仲浩[1] 

机构地区：[1]解放军第十医院麻醉手术科,甘肃武威733000 [2]第四军医大学西京医院麻醉科

出　　处：《西北国防医学杂志》2012年第6期634-635,共2页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨小潮气量机械通气(VT≤6 ml/kg)在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)麻醉中的应用效果,提高LC麻醉的安全性。方法:总结我院1999～2006年间实施小潮气量机械通气-静脉复合麻醉下行LC、胆总管探查、T管引流术的病例共2 806例,对麻醉期间患者呼吸循环改变情况、麻醉复苏时间以及并发症等进行分析。结果:小潮气量机械通气能有效降低胸腔内压力,明显减低缺氧和循环紊乱的风险,防止CO2潴留,全组无一例麻醉并发症发生。结论:小潮气量机械通气在LC麻醉中能降低胸腔内压力,减少肺部并发症,减低术后低氧血症,且血流动力学无明显改变,防止CO2潴留为中老年患者实施LC提供可靠保证。Objective：To investigate the safety and efficiency of mechanical ventilation with low tidal volume（VT≤6 ml/kg） in laparoscopic cholecystectomy（LC）.Methods：Mechanical ventilation with low tidal volume was performed in 2806 cases of LC,exploration of common bile duct and T-tube drainage.Among these cases,the alteration of respiratory and circulatory indexes,time of palinesthesia and anesthetic complications were analyzed.Results：Mechanical ventilation with low tidal volume reduced intrathoracic pressure,avoided hypoxia and circulatory disturbance as well as CO2 retention effectively,no anesthetic complications occurred.Conclusion：Mechanical ventilation with low tidal volume reduces intrathoracic pressure in LC operation,and avoids lung complications and hypoxemia after operation.It alleviates CO2 retention and causes no obvious change in hemodynamics.It is reliable especially for old patients.

关 键 词：麻醉学 小潮气量 机械通气 腹腔镜手术 

分 类 号：R614[医药卫生—麻醉学]