异丙酚和异氟醚对单肺通气时动脉氧合和肺内分流的影响  

Comparison of the effects of propofol and isoflurane on intrapulmonary shunt and oxygenation during one-lung ventilation

作　　者：彭为平[1] 黄燕虹[1] 张少云[1] 黄文庆[1] 万震威[1] 李玉卿[1] 张孟贤[1] 

机构地区：[1]广东省粤北人民医院麻醉科,512026

出　　处：《广东医学》2000年第12期1020-1021,共2页Guangdong Medical Journal

基　　金：韶关市卫生局科研立项课题

摘　　要：目的　比较异丙酚和异氟醚对单肺通气 (one -lungventilation ,OLV)时动脉氧合和肺内分流的影响。方法　选择 2 0例ASAⅠ～Ⅱ级开胸手术患者随机分为异丙酚组 (P)和异氟醚组 (I) ,每组 10例 ,麻醉诱导气管插管后P组用异丙酚 4～ 12mg/(kg·h)静脉持续输注 ;I组用异氟醚 1 5 %～ 2 %吸入维持麻醉。在麻醉后双肺通气 (two -lungventilation ,TLV) 15min(t1) ,OLV 30min(t2 ) ,OLV 6 0min(t3) ,TLV 30min(t4 )时间点抽取动脉血和右心房血 ,行血气分析检查 ,并计算肺内分流量 (Qs/Qt)。结果　OLV后t2 ,t3 与t1相比两组的Qs/Qt有明显升高 (P <0 0 5 ) ,而PaO2 和SaO2 下降非常显著(P <0 0 1) ;但两组之间t2 ,t3 比较差异无显著性 (P >0 0 5 )。结论　异丙酚与异氟醚比较并不明显增加肺内分流和降低动脉氧分压。Objective To compare effects of propofol and isoflurane on intrapulmonary shunt and oxygenation during one-lung ventilation (OLV).Methods 20 patients of ASA Ⅰ～Ⅱ undergoing thoracic operation were randomly divided into two groups with 10 patients propofol group (P group) and isoflurane group (I group). The anesthesia was maintained with infusion of 4～12 mg/(kg·h) propofol in group P, and with inhalation of 1.5%～2% isoflurane in group I. The arterial and right atrium blood were taken for blood gas analysis at the following time: TLV 15 min( t 1), OLV 30 min ( t 2), OLV 60 min( t 3), TLV 30 min( t 4), and the Qs/Qt was calculated. Results Qs/Qt increased ( P <0.05), while PaO 2 and SaO 2 decreased significantly ( P <0.01) at t 2 or t 3 compared with that at t 1. There were no significant differences between the two groups at the same time points.Conclusion Propofol was not associated with a significant increase in intrapulmonary shunt during OLV comparison with isoflurane.

关 键 词：异丙酚 异氟醚 肺内分流 单肺通气 

分 类 号：R971.2[医药卫生—药品]