小潮气量结合低水平呼气末气道正压在软镜肾脏碎石中的应用

目的:探讨小潮气量结合低水平呼气末气道正压在软镜肾脏碎石中的临床应用价值.方法:选择患者80例,分为两组,各40例,呼吸控制上,观察组采用小潮气量低呼气末正压维持,对照组采用间停呼吸处理,比较两组干预后30min血气分析结果、术毕两组TNF-a、IL-6和CRP水平及两组手术相关指标.结果:干预后30min,观察组pH水平低于对照组(P<0.05),PCO2水平低于对照组(P<0.05),术毕,观察组TNF-a、IL-6和CRP水平均低于对照组(P<0.05),观察组手术时间短于对照组(P<0.05),呼吸影响操作例数及软镜治疗失败比例低于对照组(P<0.05).结论:小潮气量结合低水平呼气末气道正压用于软镜下钬激光肾脏碎石,维持患者血气分析结果正常,显著降低手术、麻醉应激对患者影响,更利于手术操作.

The Application of Low Tidal Volume Combined with Low Levels Expiratory Positive Airway Pressure to Soft Lenses Kidney Gravel

Objective: To investigate the application value of the low tidal volume combined with low levels expiratory positive airway pressure to soft lenses kidney gravel. Methods:80 cases were divided into two groups, with 40 cases in each group. In breath control, low tidal volume combined with low levels expiratory positive airway pressure was used in the observation group, while blot's breathing treatment was used in the control group, 30min after the intervention, the blood gas analysis, TNF-a, IL-6 and CRP levels as well as procedure-related indicators in the two groups were compared. Results:30min after the intervention, pH level in the observation group was lower than that in the control group(P<0.05), PCO2 level in the observation group was lower than that in the control group( P<0.05) . After the surgery, TNF-a, IL-6 and CRP level in the observation group were significantly lower than those in the control group( P<0.05) , The operative time of the observation group was shorter than that of the control group( P<0.05) , the number of cases of respiratory and failure proportion of soft lenses treatment in the observation group were lower than those in the control group( P<0.05) . Conclusion:The low tidal volume combined with low levels expiratory positive airway pres-sure for soft lenses kidney gravel can maintain normal blood gas analysis, can significantly reduce the influence of surgery, anesthesia stress on patients, which is conductive to the surgical procedure.