参麦注射液在单肺通气患者肺内分流及动脉氧合的影响

目的：探讨参麦注射液对单肺通气（ OLV）术患者肺内分流及动脉氧合的影响。方法：择期行开胸手术单肺通气患者60例，美国麻醉医师协会（ ASA）分级和纽约心脏病协会（ NYHA）分级均为Ⅰ∽Ⅱ级。采用随机数字表法，将患者随机分为参麦注射液组（SM组，n＝30）和生理盐水对照组（NS组，n＝30）。麻醉诱导后，SM组静脉滴注参麦注射液（0．6 ml／kg加至250 ml生理盐水）；在相同时间内NS组给予等量生理盐水，于单肺通气前滴注完毕。连续观察心率（ HR）、平均动脉血压（ MAP）、气道压力（ Paw）及血流动力学指标，分别于麻醉诱导前（ T0）、单肺通气前（ T1）、单肺通气10分钟（ T2）、30分钟（ T3）、60分钟（ T4）、120分钟（ T5）、单肺通气结束后10分钟（ T6）和手术结束（ T7）时行动脉血气和混合静脉血气分析，计算肺内分流量（ QS／QT ）、肺泡∽动脉血氧分压差P（A∽a）DO2及呼吸指数（RI）。结果：SM组患者T2∽T5时的动脉血PaO2明显高于NS组（P＜0．01），而QS／QT则显著低于NS组（P＜0．01）。 SM组患者T2∽T5时的P（A∽a）DO2及RI均明显低于NS组（P＜0．01）。结论：参麦注射液用于单肺通气术患者，能有效改善动脉氧合及减少肺内分流，从而对胸科手术患者产生一定的肺保护作用。

Effects of shenmai injection on lung protection for patients undergoing one-lung ventilation

Objective：To investigate the effects of Shenmai Injection on arterial oxygenation and pulmonary shunt during one -lung ventilation （OLV） in thoracic surgery patients.Methods：Sixty American Society of Anesthesiologists （ASA）Ⅰ-Ⅱand New York Heart Association （ NYHA）Ⅰ-Ⅱpatients undergoing OLV during elective thoracic surgery were randomly allocated into two groups （ n=30 ）：Shenmai Injection group （ SM group） and normal saline control group （ NS group） .The anesthetics of induction were the same in the two groups.After induction, the patients of SM group were received intravenously Shenmai Injection （0.6 ml/kg added to 250 ml normal sa-line） , and the patients of NS group were given intravenously with equivalent normal saline at the same time , both completed before OLV . Time of liquid infusion, duration of OLV, time of anesthetic maintenance and hemodynamics were recorded .Heart rate （HR）, mean arte-rial pressure （MAP）, airway pressure （Paw） and hemodynamics indexes were continuously recorded .Arterial blood gas and mixed ve-nous blood gas were tested respectively before anesthesia induction （ T0 ） , before OLV （ T1 ） , 10 min （ T2 ） , 30 min （ T3 ） , 60 min （T4）, 120 min （T5） after OLV, 10 min after OLV over （T6） and the end of surgery （T7）, and QS/QT, alveolar-arterial differences for O2 partial pressure （ P（ A-a） DO2） and respiratory index （ RI） of each group at the above -mentioned time points were calculated . Results：There was no statistical significance in time of liquid infusion , duration of OLV, time of anesthetic maintenance , and hemody-namics indexes （P〉0.05） between the two of groups.Compared to NS group, PaO2 in SM group from T2 to T5 were higher （P〈0.01）, and QS/QT of SM group in the same period of time were lower （P＆lt;0.01）.Compared to NS group, P（A-a）DO2 and RI in SM group from T2 to T5 were both lower （P＆lt;0.01）.There was no statistically significant difference between