呼气末正压通气对术 中气体栓塞发生的影响  

EFFECT OF POSITIVE END-EXPIRATORY PRESSURE ON THE INCIDENCE RATE OF VENOUS AIR EMBOLISM DURING SURGERY

作　　者：刘文义[1] 王卿宇 徐敏[2] 徐永生 陈彦霖 邵翠华[3] LIU Wenyi;WANG Qingyu;XU Min;XU Yongsheng;CHEN Yanlin;SHAO Cuihua(Department of Anesthesio-logy,The Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266100 [2]青岛大学附属医院运动医学科,山东青岛266100 [3]青岛大学附属医院产科,山东青岛266100

出　　处：《青岛大学学报（医学版）》2020年第6期715-718,共4页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市科技局立项课题(10-3-4-7-8-jch)。

摘　　要：目的采用经食管超声心动图(TEE)观察后路腰椎椎体间融合术中静脉气体栓塞(VAE)发生率及呼气末正压通气(PEEP)对VAE发生率的影响。方法将120例拟全麻下行后路腰椎椎体间融合术病人随机分为对照组、PEEP1组和PEEP2组,各40例。3组术中分别设置PEEP为0、0.49、0.98 kPa,同时采用TEE监测并评估各组VAE分级。结果 对照组VAE主要为Ⅰ级和Ⅱ级,PEEP1组和PEEP2组VAE主要为0级和Ⅰ级,3组VAE分级比较差异有显著性(H=30.24,Z=1.98~5.43,P<0.01)。结论 手术中PEEP可有效降低后路腰椎椎体间融合术病人VAE的发生率,提高手术安全性。ObjectiveTo investigate the effect of positive end-expiratory pressure(PEEP)on the incidence rate of venous air embolism(VAE)during posterior lumbar interbody fusion(PLIF)using transesophageal echocardiography(TEE).MethodsA total of 120 patients who planned to undergo PLIF under general anesthesia were randomly divided into control group,PEEP1 group,and PEEP2 group,with 40 patients in each group,and in these three groups,PEEP was set to 0,0.49,and 0.98 kPa,respectively.TEE was used to monitor and evaluate the grade of VAE.ResultsGradeⅠ/ⅡVAE was mainly observed in the control group,grade 0 VAE was mainly observed in the PEEP1 group,and gradeⅠwas mainly observed in the PEEP2 group;there was a significant difference in the grade of VAE between the three groups(H=30.24,Z=1.98-5.43,P<0.01).ConclusionFor patients undergoing PLIF,PEEP can effectively reduce the incidence rate of VAE during surgery and improve surgical safety.

关 键 词：脊柱融合术 栓塞 空气 正压呼吸 超声心动描记术 经食管 

分 类 号：R614[医药卫生—麻醉学]