沙丁胺醇对腹腔镜手术中慢性阻塞性肺疾病患者呼吸动力学的影响  

Effects of salbutamol on pneodynamics during laparoscopic operation in patients with chronic obstructive pulmonary disease

作　　者：周建辉[1] 陈仁云 

机构地区：[1]平湖市中医院麻醉科,浙江平湖314200

出　　处：《中国新药与临床杂志》2013年第10期838-841,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察麻醉诱导前吸入沙丁胺醇气雾剂对腹腔镜手术中慢性肺阻塞性肺疾病（COPD）患者呼吸动力学的影响。方法拟行腹腔镜手术的COPD患者40例，随机分成两组，每组20例。试验组给予沙丁胺醇气雾剂200μg（2揿）后面罩吸氧，对照组单纯面罩吸氧，30min后开始麻醉诱导。两组麻醉诱导及维持方法相同，术中建立人工气腹。监测入室时（T0）、麻醉诱导前（T1）、插管后5min（T2）、人工气腹后5min（T3）及30min（T4）的血气分析指标，记录T2-T4时的呼吸动力学参数，并观察不良反应。结果试验组T1-T4时的PaC02均低于对照组，pH值和Pa02高于对照组（P〈0．05或P〈0．01）。两组T3、T4时点的气道峰压、气道平台压、气道阻力均高于T2时点，而胸肺顺应性下降（P〈0．05或P〈0．01）；试验组同时点气道峰压、气道平台压、气道阻力低于对照组，胸肺顺应性高于对照组（P〈0．05或P〈0．01）。无明显不良反应发生。结论沙丁胺醇气雾剂能改善腹腔镜手术中COPD患者的缺氧状态．降低气道压力和气道阻力，增加胸肺顺应性。利于术中呼吸管理。AIM To study the effects of salbutamol aerosol inhalation prior to pneodynamics during laparoscopic operation in patients with chronic obstructive pulmo anesthesia induction on nary disease （ COPD）. METHODS Forty patients with concomitant COPD, scheduled for laparoscopic operation were randomly allocated into observation group （n = 20） and control group （n = 20）. Salbutamol aerosol （200 μg, two puffs） was administered via mask before oxygenation in the observation group according to instructions, and no aerosol was given in the control group. Anesthesia induction was initiated after 30 minutes oxygenation in both groups. The anesthesia induction and maintenance were performed under the same protocols in the two groups, and artificial pneumoperitoneum was constructed during operation. The indexes of blood gas analysis were monitored at different time points, including entering operating room （To）, before anesthesia induction （T1）, 5 minutesafter intubation （T2）, 5 minutes after pneumopertioneum （T3） and 30 minutes after pneumopertioneum （1＂4）. The pneodynamics parameters and adverse reactions were recorded. RESULTS The level of PaCO2 in the observation group was lower than that in the control group at T1 to T4, but pH acidity and Pa02 were higher （P 〈 0.05 or P 〈 0.01） comparing to the control group. Peak airway pressure, plateau pressure and airway resistance at T3 and 1＂4 were higher than those at T2 in both groups, but chest-lung compliance was lower （P 〈 0.05 or P 〈 0.01）. Peak airway pressure, plateau pressure and airway resistance in the observation group were lower than those in the control group, but chest-lung compliance was higher at the same time points （P 〈 0.05 or P 〈 0.01 ）. There were no obvious adverse reactions recorded in two groups. CONCLUSION Salbutamol aerosol inhalation can correct anerobic condition, reduce airway pressure and airway resistance, compliance during laparoscopic operation in patients with COPD, which is benefit du

关 键 词：沙丁胺醇 肺疾病 慢性阻塞性 腹腔镜检查 呼吸动力学 

分 类 号：R974[医药卫生—药品]