氧化亚氮吸入对支气管阻塞器行单肺通气时肺塌陷效果的影响  

Effect of N_2O in mixed inspiratory gas on lung collapse during one-lung ventilation with bronchial blocker

作　　者：余露[1] 蒋伟[1] 冯顺华[1] 顾达民[1] 葛志军[1] 韩超[1] 

机构地区：[1]宜兴市人民医院麻醉科,江苏省214200

出　　处：《江苏医药》2016年第9期1034-1036,共3页Jiangsu Medical Journal

摘　　要：目的研究支气管阻塞器行肺隔离时,单肺通气前吸入气中混合氧化亚氮(N_2O)对单肺通气后非通气侧肺塌陷效果的影响。方法选择电视胸腔镜下肺叶切除手术患者30例,随机均分成N_2O组和纯氧组(O_2组)。N_2O组从面罩预氧去氮至单肺通气前吸入N_2O/O2的混合气(吸入气中的氧浓度分数为0.5);O_2组全程吸入100%纯氧。采用口头评定量表评价单肺通气后1、5、10min时肺塌陷程度,同时在麻醉前、单肺通气前、单肺通气5、10min取动脉血测PaO_2值。结果两组患者肺塌陷评分在单肺通气1min时无统计学差异(P>0.05),而在单肺通气后5、10min时N_2O组优于O_2组(P<0.05)。N_2O组在单肺通气前PaO_2值低于O_2组(P<0.05),其余各时间点两组PaO_2值均无统计学差异(P>0.05)。结论支气管阻塞器行肺隔离时,单肺通气前吸入N_2O/O_2的混合气能改善单肺通气后肺塌陷效果,但不影响术中氧合。Objective To observe the effect of nitrous oxide（N2O）inhalation on the effectiveness of lung collapse during one-lung ventilation（OLV）with bronchial blocker.Methods Thirty patients undergoing lobectomy under video-assisted thoracoscope under general anesthesia and OLV were equally randomized into two groups.Before OLV,the patients in group A was ventilated with mixed gas of N_2O and O_2（FiO_2=0.5）and those in group B with pure oxygen.The lung collapse during OLV was evaluated by verbal rating scale at 1,5,and 10 minutes.The PaO_2 was measured as well.Results The score of verbal rating scale in group A at one minute of OLV was not significantly different from that in group B（P〈0.05）,which at 5and 10 minutes was better in group A than that in group B（P〈0.05）.The PaO_2 before OLV was lower in group A than that in group B（P〈0.05）,which at the other time points was not significantly different between two groups（P〈0.05）.Conclusion Inhalation of mixed gases of N_2O and O_2 before OLV can improve the effectiveness of lung collapse without worse influence on oxygenation in the patients undergoing lobectomy under general anesthesia with bronchial blocker.

关 键 词：单肺通气 氧化亚氮 

分 类 号：R614[医药卫生—麻醉学]