异丙酚复合瑞芬太尼在肺叶切除术单肺通气麻醉中的应用

目的探讨瑞芬太尼在肺叶切除术单肺通气麻醉中的临床应用效果。方法回顾性分析了从2011年3月至2013年3月期间于我院行肺叶切除术时实施异丙酚复合瑞芬太尼单肺通气麻醉的45例患者，考察不同时段的肺内分流率和患者术后恢复情况。结果肺内分流率在双肺通气及单肺通气半小时、单肺通气1h、重复双肺通气半小时这几个时间点均比文献报道的其他麻醉给药方式低，患者的呼吸恢复时间、睁眼时间、拔管时间、定向力恢复时间、离开恢复室时间比文献报道的其他麻醉给药方式短。结论瑞芬太尼在肺叶切除术单肺通气麻醉中应用使血流动力学变化更平稳，术后苏醒和恢复质量更佳，值得临床推广。

Application of Propofol Combined with Remifentanil in One-lung Ventilation Anesthesia During Pulmonary Lobectomy

Objectives To discuss the application effect of propofol combined with remifentanil in one-lung ventilation anesthesia during pulmonary lobectomy. Methods 45 cases who received one-lung ventilation anesthesia of propofol combined with remifentanil during pulmonary lobectomy from March, 2011 to March, 2013 were retrospectively analyzed. Incidence of intrapulmonary shunt at different times and postoperative recovery were investigated. Results The incidences of intrapulmonary shunt at the time of two-lung ventilation （TLV） for 30 min, one-lung ventilation （OLV） for 30 min, OLV for lh, renew TLV for 30 min are lower than the ones in other anesthesia methods reported in reference. The time of opening eyes, time of spontaneous breathing, extubation time, orientation force recovery time, time to leave recovery room are shorter than the ones in other anesthesia methods reported in reference. Conelusions The application of propofol combined with remifentanil in one-lung ventilation anesthesia during pulmonary lobectomy makes the hemodynamic change smoother and obtain better analepsia and recovery quality. It is worthy of clinical promotion.