高流量鼻导管通气对胸腔镜手术单肺通气时非通气侧肺氧合功能的影响  

Effect of high flow nasal catheter ventilation on non-ventilated lung oxygenaion during single lung ventilation in thoracoscopic surgery

作　　者：谈海杰 熊祥生 孙林森 孙小婧 姚盛来 朱学芳 Tan Haijie;Xiong Xiangsheng;Sun Linsen;Sun Xiaojing;Yao Shenglai;Zhu Xuefang(Department of Anesthesiology,Huai′an Hospital affiliated to Yangzhou University(The Fifth People′s Hospital of Huai′an),Huai′an 223300,China)

机构地区：[1]扬州大学附属淮安医院(淮安市第五人民医院)麻醉科,淮安223300

出　　处：《中国临床实用医学》2024年第4期41-45,共5页China Clinical Practical Medicine

摘　　要：目的探讨高流量鼻导管通气(HFNC)对胸腔镜手术单肺通气期间非通气侧肺氧合功能的影响。方法本研究为随机对照研究,选取2022年4月至2023年10月扬州大学附属淮安医院(淮安市第五人民医院)麻醉科参与手术的60例择期行双腔管气管插管全身麻醉胸腔镜下肺部分切除术的患者,男37例,女23例,年龄(62.73±9.75)岁,年龄范围为27~78岁,采用随机数表法将患者随机分为常规组与HFNC组,每组30例,常规组行常规单肺通气,HFNC组在常规组的基础上对非通气侧肺行高流量鼻导管通气。比较两组患者麻醉前及单肺通气30 min后的平均动脉压、心率、脉搏血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数及单肺通气过程中转双肺通气的情况。结果单肺通气30 min后,HFNC组SpO_(2)[(98.13±1.11)%]、PaO_(2)[(119.43±13.29)mmHg,1 mmHg=0.133 kPa]及氧合指数[(154.33±36.46)mmHg]高于常规组[(96.90±1.52)%、(96.33±19.91)mmHg、(135.00±35.48)mmHg],PaCO_(2)[(41.33±3.09)mmHg]低于常规组[(43.13±3.28)mmHg],差异有统计学意义(P<0.05)。常规组单肺通气转双肺通气比率[26.7%(8/30)]高于HFNC组[6.7%(2/30)],差异有统计学意义(P<0.05)。结论胸腔镜手术单肺通气期间,对非通气侧肺应用HFNC可提高SpO_(2)、PaO_(2)、氧合指数,降低PaCO_(2)及术中单肺通气转为双肺通气的比率。Objective To investigate the effect of high-flow nasal cannula oxygen therapy(HFNC)on oxygenation of non-ventilated lung during one-lung ventilation in thoracoscopic surgery.Methods This study was a randomized controlled study,a total of 60 patients with elective thoracoscopic partial pulmonary resection by double-lumen trachea intubation and general anesthesia who received department of Anesthesiology of Huai′an Hospital affiliated to Yangzhou University(The Fifth People′s Hospital of Huai′an)from April 2022 to October 2023,including 37 males and 23 females,aged(62.73±9.75)years old,ranging form 27 to 78 years old.Patients were randomly divided into conventional group and HFNC group by random number table method,with 30 cases in each group.The conventional group received routine single-lung ventilation,and the HFNC group received high-flow nasal catheter ventilation on the non-ventilated lung on the basis of the conventional group.The mean arterial pressure,heart rate,pulse oxygen saturation(SpO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),oxygenation index and the conversion to double lung ventilation during single lung ventilation were compared between the two groups before anesthesia and 30 minutes after single lung ventilation.Results After 30 minutes of single lung ventilation,SpO_(2)[(98.13±1.11)%],PaO_(2)[(119.43±13.29)mmHg,1mmHg=0.133 kPa]and oxygenation index[(154.33±36.46)mmHg]in HFNC group were higher than those in the conventional group[(96.90±1.52)%,(96.33±19.91)mmHg,(135.00±35.48)mmHg].PaCO_(2)[(41.33±3.09)mmHg]in HFNC group was lower than that of conventional group[(43.13±3.28)mmHg],and the differences were statistically significant(P<0.05).The ratio of single lung ventilation to double lung ventilation in conventional group[26.7%(8/30)]was higher than that in HFNC group[6.7%(2/30)],and the difference was statistically significant(P<0.05).Conclusions During single lung ventilation in thoracoscopic surgery,HFNC can increase S

关 键 词：胸腔镜 单肺通气 高流量鼻导管通气 缺氧性肺血管收缩 氧合指数 

分 类 号：R614[医药卫生—麻醉学]