压力控制容量保证通气模式对老年行后腹膜腹腔镜术呼吸功能的影响  

Effect of Pressure-controlled Volume-Assured Ventilation Mode on Respiratory Function in Elderly Performing Retroperitoneal Laparoscopy

作　　者：蒋宇智[1] 刘晶晶 谢力 Jiang Yu-zhi;Liu Jing-jing;Xie Li(Department of Anesthesiology,Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,Jiangsu Province,China;Department of Anesthesiology,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,Jiangsu Province,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)麻醉科,江苏南京2210006 [2]南京医科大学第四附属医院麻醉科,江苏南京210031

出　　处：《中外医药研究》2022年第10期24-26,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:观察压力控制容量保证通气(PCV-VG)模式对老年患者行后腹膜腹腔镜手术呼吸功能的影响。方法:选取2021年1月-2022年6月收治的行后腹膜腹腔镜手术的老年患者60例为观察对象,采用随机数字表法分为对照组与观察组,各30例。观察组采用压力控制容量保证通气,对照组采用容量控制通气。比较两组患者不同时间点呼吸力学参数、肺氧合指标。结果:气腹建立后5 min(T_(2))、气腹建立后30 min(T_(3))、气腹建立后1 h(T_(4))、停止气腹后10 min(T_(5))时,两组患者气道峰压、平均气道压、动态肺顺应性水平均升高,观察组气道峰压、平均气道压低于对照组,观察组动态肺顺应性高于对照组,差异有统计学意义(P<0.05);T_(2)、T_(3)、T_(4)、T_(5)时,观察组pH高于对照组,二氧化碳分压低于对照组,差异有统计学意义(P<0.05)。结论:PCV-VG在老年患者行后腹膜腹腔镜手术中对呼吸功能影响小,可以用更低的气道峰压、平均气道压获得更好的通气效果,对老年患者后腹膜腹腔镜手术围术期肺保护效果好。Objective:To observe the effect of pressure-controlled volume-guaranteed ventilation(PCV-VG)mode on respiratory function in elderly patients undergoing retroperitoneal laparoscopic surgery.Methods:60 elderly patients admitted to underwent retroperitoneal laparoscopic surgery from January 2021 to June 2022 were selected as observation subjects,and were divided into control and observation groups using the random number table method,with 30 cases each.Pressure-controlled volumeguaranteed ventilation was used in the observation group,and volume-controlled ventilation was used in the control group.Respiratory mechanics parameters and pulmonary oxygenation indexes were compared between the two groups of patients at different time points.Results:At 5 min after pneumoperitoneum establishment(T_(2)),30 min after pneumoperitoneum establishment(T_(3)),1 h after pneumoperitoneum establishment(T_(4)),and 10 min after cessation of pneumoperitoneum(T_(5)),the levels of peak airway pressure,mean airway pressure,and dynamic lung compliance increased in both groups,and the peak airway pressure and mean airway pressure in the observation group were lower than those in the control group,and the dynamic lung compliance in the observation group was higher than that in the control group.The differences were statistically significant(P<0.05).pH was higher in the observation group than in the control group at T_(2),T_(3),T_(4)and T_(5),and partial pressure of carbon dioxide was lower than in the control group,and the differences were statistically significant(P<0.05).Conclusion:PCV-VG has little effect on respiratory function in elderly patients undergoing retroperitoneal laparoscopic surgery,can obtain better ventilation with lower peak airway pressure and mean airway pressure,and has good effect on perioperative lung protection in elderly patients undergoing retroperitoneal laparoscopic surgery.

关 键 词：老年 后腹膜腹腔镜 呼吸功能 氧合指数 压力控制容量保证通气 

分 类 号：R47[医药卫生—护理学]