深肌松下肺复张在腹腔镜妇科手术后肺部并发症的影响研究  

Study on the Effect of Lung Recruitment Under Deep Neuromusclar Block Panasonic Reopening on Pulmonary Complications After Laparoscopic Gynecological Surgery

作　　者：周引凤[1] 程周[1] 陈勇[1] Zhou Yinfeng;Cheng Zhou;Chen Yong(Departmentof Operative Anesthesia,Zhongshan People's Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院科室手术麻醉一科,广东中山528403

出　　处：《哈尔滨医药》2022年第2期42-44,共3页Harbin Medical Journal

摘　　要：目的探讨深肌松下肺复张对腹腔镜妇科手术后肺部并发症的影响。方法将行妇科腹腔镜手术患者随机分为观察组和对照组各45例。两组患者均行全麻下气管插管,插管前进行深肌松诱导,对照组给予机械通气;观察组在此基础上行间断性肺复张。观察两组患者人工气腹各时间段血流动力学及肺功能改变;比较两组术后72h内肺部不良反应例数和比例。结果气腹完成时的肺顺应性和氧合指数、气腹45min时氧合指数和低氧血症两组差异无统计学意义(P>0.05);气腹45min时肺顺应性、气腹90 min、放气时的肺顺应性和氧合指数以及肺部感染、肺不张、气胸、呼吸困难和咳嗽等观察组明显低于对照组(P<0.05)。结论深肌松下腹腔镜妇科手术患者给予肺复张,可有效改善人工气腹时的肺功能,明显减少术后肺部并发症,值得广泛推广。Objective To investigate the effect of deep muscle panasonic reopening on the pulmonary complications after laparoscopic gynecological surgery.Methods Patients who underwent gynecological laparoscopic surgery were randomly divided into observation group and control group(n=45).Both groups received endotracheal intubation under general anesthesia and deep muscle relaxation induction before intubation,while the control group was given mechanical ventilation.The observation group had intermittent pulmonary reextension on this basis.The changes of hemodynamics and lung function in each period of artificial pneumoperitoneum in two groups were observed.The number and proportion of pulmonary adverse reactions within 72 hours after operation were compared between the two groups.Results There were no significant differences in pulmonary compliance and oxygenation index at pneumoperitoneum completion,oxygenation index at pneumoperitoneum 45min and hypoxemia between the two groups(P>0.05).The lung compliance and oxygenation index at pneumoperitoneum for 45min,pneumoperitoneum for 90 min,ventilated air,pulmonary infection,atelectasis,pneumothorax,dyspnea and cough in the observation group were significantly lower than those in the control group(P<0.05).Conclusion In patients undergoing deep muscle panasonic laparoscopic gynecological surgery,pulmonary reopening can effectively improve the lung function during artificial pneumoperitoneum and significantly reduce postoperative pulmonary complications,which is worthy of wide promotion.

关 键 词：深肌松 肺复张 腹腔镜 妇科手术 肺部并发症 

分 类 号：R614.2[医药卫生—麻醉学]