PCV-VG模式对腹腔镜直肠癌根治术老年患者血流动力学及呼吸功能的影响  

Effects of PCV-VG mode on hemodynamics and respiratory function in elderly patients undergoing laparoscopic radical resection of rectal cancer

作　　者：陈晓[1] 曲振华[1] 秦延[2] CHEN Xiao;QU Zhenhua;QIN Yan(Department of Anesthesiology,Xingtai People′s Hospital,Xingtai,Hebei 054000;Department of Gastrointestinal Oncology Surgery,Xingtai People′s Hospital,Xingtai,Hebei 054000)

机构地区：[1]邢台市人民医院麻醉科,河北邢台054000 [2]邢台市人民医院胃肠肿瘤外科,河北邢台054000

出　　处：《郑州大学学报（医学版）》2022年第3期410-413,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:比较压力控制容量保证通气(PCV-VG)与容量控制通气(VCV)模式对腹腔镜直肠癌根治术老年患者血流动力学及呼吸功能的影响。方法:择期行腹腔镜直肠癌根治术老年患者128例,依据麻醉中机械通气模式将患者分为对照组(术中应用VCV)和试验组(术中应用PCV-VG),各64例。监测并比较2组患者麻醉诱导前(T0)、气管插管术后10 min(T1)、建立气腹后30 min(T2)、气腹建立后60 min(T3)、气腹解除后20 min(T4)的血流动力学指标平均动脉压(MAP)、心率(HR);监测并比较动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动态肺顺应性(Cdyn)、气道峰压(P_(peak))、气道平台压(P_(plat))。结果:2组术中MAP及HR的变化差异无统计学意义(P>0.05)。2组患者的PaO_(2)在T2时间点均有一过性轻度降低,PaCO_(2)有一过性轻度升高,试验组T2时的PaO_(2)较对照组降低(P<0.05)。与T1时间点相比,2组患者T2、T3时间点的P_(peak)及P_(plat)均升高,Cdyn均下降(P<0.05)。试验组T2、T3时间点的Cdyn较对照组升高,P_(peak)降低(P<0.05)。结论:PCV-VG模式用于腹腔镜直肠癌根治术老年患者不影响血流动力学,但可降低术中P_(peak)及P_(plat),改善Cdyn,对老年患者更适用。Aim:To investigate the effects of pressure-controlled ventilation-volume guarantee(PCV-VG)and volume-controlled ventilation(VCV)on hemodynamics and respiratory function in elderly patients undergoing laparoscopic radical resection of rectal cancer.Methods:A total of 128 elderly patients undergoing laparoscopic radical resection of rectal cancer were divided into control group(intraoperative application of VCV)and trial group(intraoperative application of PCV-VG),with 64 cases in each group.The hemodynamics parameters mean arterial pressure(MAP),heart rate(HR)of the two groups at five time points before anesthesia induction(T0),10 mins after intubation(T1),30 mins after establishment of pneumoperitoneum(T2),60 mins after pneumoperitoneum(T3),and 20 mins after release of pneumoperitoneum(T4)were measured and compared.Blood gas analysis[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and respiratory function[dynamic pulmonary compliance(Cdyn),peak airway pressure(P_(peak)),airway plateau pressure(P_(plat))]at T0 to T4 time points were measured and compared,too.Results:There was no difference in MAP or HR between the two groups(P>0.05).The PaO_(2) of the two groups decreased slightly at T2 time point,the PaO_(2) increased slightly,and the PaO_(2) at T2 time point of the trial group decreased compared with the control group(P<0.05).Compared with T1 time point,the P_(peak) and P_(plat) in the two groups at T2 and T3 time points increased,and the Cdyn decreased(P<0.05).The Cdyn at T2 and T3 time points in the trial group was higher than that in the control group,while the P_(peak) was lower(P<0.05).Conclusion:The application of PCV-VG in elderly patients undergoing laparoscopic radical resection of rectal cancer could reduce P_(peak) and P_(plat),and improve Cdyn.PCV-VG is more suitable for elderly patients.

关 键 词：压力控制容量保证通气 容量控制通气 腹腔镜直肠癌根治术 老年人 血流动力学 呼吸功能 

分 类 号：R735.3[医药卫生—肿瘤]