低流量单肺通气对肺内分流和动脉氧分压的影响  

Effects of low flow one-lung ventilation on intrapulmonary shunt and arterial oxygen pressure

作　　者：胡彦艳[1] 秦丹丹[1] 叶凤青[1] 黄中华[1] 李静[1] 张学刚[1] 

机构地区：[1]广西壮族自治区人民医院麻醉科,南宁市530021

出　　处：《实用医学杂志》2013年第8期1258-1260,共3页The Journal of Practical Medicine

基　　金：广西科学基金资助项目(编号:桂科青0339020)

摘　　要：目的:观察低流量单肺通气对肺内分流和动脉氧分压的影响。方法:40例需单肺通气的择期肺癌手术患者,ASAⅠ或Ⅱ级,随机分为常流量组(A组)和低流量组(B组),每组20例。两组单肺通气前吸入高流量的氧气4L/min和1%安氟醚,10min后将A组氧气流量调为3L/min,B组调为1L/min,两组每60min给予高流量的新鲜气体4L/min吸入5min,手术结束前30min停止吸入安氟醚,恢复流量至4L/min。在单肺通气前(T0)及单肺通气后15(T1)、30(T2)、45(T3)、60(T4)min及恢复双肺通气30min(T5)时测定动脉及混合静脉血血气分析,记录pH、PaCO2、PaO2,计算肺内分流量(Qs/Qt)。结果:两组患者单肺通气各时点较双肺通气时Qs/Qt增加、PaO2下降,差异有统计学意义(P<0.01);两组间Qs/Qt、PaO2差异无统计学意义(P>0.05)。结论:低流量单肺通气对肺内分流和动脉氧分压无明显影响。Objective To investigate the effects of low flow one-lung ventilation on intrapulmonary shunt and arterial oxygen pressure. Methods 40 patients, ASA grade Ⅰ or Ⅱ , scheduled for lung cancer surgery and one-lung ventilation （OLV） were randomly divided into 2 groups （each n = 20）： normal flow group （Group A） and low flow group （GroupB）. Before OLV, patients in the two group received 4 L/min of high oxygen flow and inhaled 1% anflurane for 10 minutes, then the oxygen flow was decreased to 3 L/min in Group A and 1 L/rain in Group B. Every 60 minutes, all the patients received 4 L/min of high flow fresh air for 5rain during OLV. 30 minutes before surgery, the anflurane was ceased and the flow of oxygen was increased to 4L/rain. Blood gas analysis was determined before OLV （To） and at 15 min （T1）, 30 min （T2）, 45 rain （T3）, 60 min （T4） after OLV, and 30min （Ts） after two-lung ventilation. PaCO2, pH, PaO2 were recorded and Qs/Qt was calculated. Results Qs/Qt was increased and PaO2 was decreased from T1 to T, when compared with those at To in the two groups （P 〈 0.01）, there was no significant difference in pH, PaCO2, Qs/Qt, PaO2 from To to T5 between the two groups. Conclusion Low flow one-lung ventilation had no significant effect on intrapulmonary shunt and arterial oxygen pressure.

关 键 词：低流量麻醉 单肺通气 肺内分流 低氧 二氧化碳蓄积 

分 类 号：R614[医药卫生—麻醉学]