自制低压给氧装置在胸科手术中的应用及效果评价  

作　　者：刘胜强[1] 万政佐[1] 陈欣[1] 龚国丽[1] 周蓉[1] 温小红[2] 

机构地区：[1]浙江省杭州市中医院,310007 [2]浙江大学医学院附属第一医院,310003

出　　处：《浙江临床医学》2022年第1期120-121,124,共3页Zhejiang Clinical Medical Journal

基　　金：杭州市科技发展计划项目(20180533B53)。

摘　　要：目的评价自制低压给氧装置在胸科手术中的临床应用及效果.方法择期胸科手术患者60例,性别不限,年龄18~75岁,ASA分级Ⅰ~Ⅱ级.采用随机数字表法分为2组(n=30):单肺通气后术侧管空置(A组);单肺通气后低压给氧装置用于术侧肺吹氧(B组).观察麻醉诱导前(T1),双肺通气平卧位(T2),开胸后单肺通气15min(T3),单肺通气30min(T4),单肺通气45min(T5),术毕双肺通气平卧位(T6),术后6h(T7)时记录动脉血气PaO_(2)值.采用Campos肺萎陷分级法进行术中肺萎陷程度评价.结果T1-4时点,两组PaO_(2)比较差异无统计学意义(P>0.05);单肺通气时T5时点,B组PaO_(2)高于A组,差异有统计学意义(P<0.05);双肺通气时两组患者T2时PaO_(2)高于T6,T6时B组PaO_(2)高于A组,差异有统计学意义(P<0.05);T7时点B组PaO_(2)高于A组,差异有统计学意义(P<0.05);两组患者均顺利完成手术,手术医师对肺萎陷满意,差异无统计学意义(P>0.05).结论自制低压给氧装置可用于胸科手术单肺通气时术侧肺吹氧,安全有效且不影响手术操作.Objective To evaluate the clinical application and effect of self-made low pressure oxygen supply device in thoracic surgery.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 18 to 75 years undergoing elective thoracic surgery with ASA grade Ⅰ~Ⅱ were divided into 2 groups(n=30 each)using a random number table:the non-ventilatory side tube was empty after one-lung ventilation(OLV)(Group A);low pressure oxygen supply device after OLV was used for oxygen blowing on the operative side(Group B).Before induction of anesthesia(T1),at the supine position with TLV before operation(T2),at 15 min of OLV after thoracotomy(T3),at 30 min of OLV(T4),at 45 min of OLV(T5),at the supine position with TLV after operation(T6),and at 6 hours after operation(T7),the arterial blood gas PaO_(2) were recorded.The degree of intraoperative lung collapse was evaluated by Campos classification.Results At time T1~4,there was no significant difference in PaO_(2) between the two groups(P>0.05).At T5 of one-lung ventilation,PaO_(2) in group B was higher than that in group A(P<0.05);At T2,PaO_(2) was higher than T6,and at T6,and PaO_(2) was higher than A in group B(P<0.05).PaO_(2) in group B was higher than that in group A at T7(P<0.05).Both groups of patients successfully completed the operation,the surgeon was satisfied with the lung collapse(P>0.05).Conclusion The self-made low pressure oxygen supply device can be used to ventilate the lungs on the operative side during one lung ventilation in thoracic surgery,which is safe,effective and does not affect the operation.

关 键 词：胸科手术 单肺通气 低氧血症 持续气道正压通气 

分 类 号：R47[医药卫生—护理学]