单肺通气期间麻醉期用药对肺内分流的影响  

Effects of drugs during anesthesia with one lung ventilation on pulmonary shunt fraction

作　　者：纪凡层[1] 牟爱珍[1] 

机构地区：[1]潍坊市人民医院麻醉科,261041

出　　处：《国际麻醉学与复苏杂志》2016年第2期157-159,183,共4页International Journal of Anesthesiology and Resuscitation

基　　金：潍坊市科技发展计划（20121164）

摘　　要：背景 低氧血症是单肺通气（one lung ventilation,OLV）期间最常见的并发症.缺氧性肺血管收缩（hypoxic pulmonary vasoconstriction,HPV）是肺血管对局部低氧分压的反射性收缩,可以减少肺内分流（pulmonary shunt fraction,Qs/Qt）、维持动脉血氧分压（partial pressure of arterial oxygen,PaO2）、防止低氧血症的发生.目的 探讨OLV期间麻醉期用药对Qs/Qt的影响,指导临床应用.内容 综述OLV期间麻醉期用药对机体HPV、Qs/Qt和PaO2的影响.趋向 OLV期间麻醉期用药可以对HPV产生抑制或增强作用,从而影响Qs/Qt和PaO2.临床上要避免使用抑制HPV作用、增加Qs/Qt的药物,防止患者出现低氧血症.Background Hypoxemia is one of the most common complications during one lung ventilation（0LV）. Hypoxemia pulmonary vasoconstriction （HPV） is a reflex contraction of vascular smooth muscle in the pulmonary circulation in response to low regional partial pressure of oxygen. It can decrease pulmonary shunt fraction （Qs/Q0 and improve oxygenation. Objective To discuss the effects of drugs during anesthesia with OLV on Qs/Qt. Content Many drugs during anesthesia have an effect on HPV, Qs/Qt and oxygenation. Trend Drugs during anesthesia with 0LV can inhibit or enhance the response of HPV, increase or decrease the Qs/Qt. We should avoid of drugs that inhibit the response of HPV and increase Qs/Qt. It can help patients to avoid of hypoxia.

关 键 词：单肺通气 药物 缺氧性肺血管收缩 肺内分流 

分 类 号：R614[医药卫生—麻醉学]