七氟醚对单肺通气时肺顺应性的影响  

The Impact of Sevoflurane on Lung Compliance during oOne-lung Ventilation

作　　者：陈志峰[1] 高峰[1] 陈丹娜[1] 蔡杰衡[1] 

机构地区：[1]广东药学院附属第一医院,广东广州510080

出　　处：《中国医药指南》2013年第32期325-326,共2页Guide of China Medicine

摘　　要：目的分析单肺通气时七氟醚在不同最低有效浓度(MAC)下对肺顺应性产生的不同影响。方法左侧开胸手术的39例患者,平均分成三组。三组患者在手术前的麻醉诱导均使用芬太尼、力月西、维库溴铵和依托咪酯,手术过程中的维持麻醉方法用七氟醚一组0.5MAC,二组1.0MAC,三组1.5MAC。手术过程中用双腔支气管控制右肺呼吸。在单肺通气0min、1min、3min、5min、15min时记录肺部的气道压、血氧饱和度、肺顺应性、呼气末二氧化碳浓度、平均动脉压。结果患者手术时的单肺通气导致肺的顺应性下降明显,其中第三组与第一组、第二组之间的差异均存在统计学意义(P<0.05)。结论单肺通气时,维持肺内七氟醚1.5MAC可以明显增强肺顺应性,而当七氟醚MAC<1.0时不会改善肺的顺应性。Objective To research the different influence of sevoflurane under different minimum alveolar concentration（MAC） on lung compliance during single lung ventilation. Methods 39 patients with open chest surgery on left side, were divided into three groups on average. Patients of three groups received preoperative anesthesia induction using fentanyl, midazolam, succinylcholine and etomidate. And 1 group received 0.5 MAC sevoflurane, 2 group 1.0 MAC and 3 group 1.5 MAC to maintain anesthesia method in the process of operation. Double cavity bronchial was used to control right lung breathing during procedure. the lung airway pressure, oxygen saturation, lung compliance, expiratory end carbon dioxide concentration, mean arterial pressure were recorded at 0 min, 1 minute, 3 minutes, 5 minutes and 15 minutes of one-lung ventilation. Results Single lung ventilation of patients during the operation resulted in a decline in the compliance of the lung. Among them there was a statistical significance between the third group and the first and second group（P〈0.05）. Conclusion During one-lung ventilation, maintaining sevoflurane with 1.5 MAC in lungs can obviously strengthen the lung compliance. However when sevoflurane with a MAC less than 1.0, it will not improve the compliance of the lung.

关 键 词：单肺通气 肺顺应性 七氟醚 

分 类 号：R614[医药卫生—麻醉学]