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不同通气模式对老年胸科手术患者呼吸和循环的影响
引用本文:邓立强. 不同通气模式对老年胸科手术患者呼吸和循环的影响[J]. 昆明医科大学学报, 2016, 37(5)
作者姓名:邓立强
作者单位:(1)普洱市人民医院麻醉科,云南 普洱 665000;2)云南省第一人民医院麻醉科,云南 昆明 650032)
基金项目:[基金项目]云南省教育厅科学研究基金资助项目(2014Z037)
摘    要:[摘要]目的 探讨容量控制通气(VCV)、压力控制通气(PCV)和压力控制通气-容量保证(PCV-VG)这3种不同通气模式对老年胸外科手术患者呼吸和循环的影响.方法 36例择期开胸手术老年患者,随机均分为VCV、PCV和PCV-VG组.分别记录术前,OLV后20、40、60 min及恢复双肺通气后20 min时患者血流动力学、通气和动脉血气的各项参数.结果 PCV和PCV-VG组患者的Ppeak值明显低于VCV组(P<0.05),而PCV和PCV-VG组之间比较,患者的Ppeak值无明显差异(P>0.05).在OLV 后40 min时PCV和PCV-VG组患者的PaO2高于VCV组(P<0.05).PCV-VG组患者PaO2较高,但与PCV组比较,在OLV期间并无明显改善(P >0.05).结论 胸外科老年患者手术实施OLV时,使用PCV和PCV-VG通气模式可提高动脉氧合作用和降低气道压力,较VCV通气模式更具有显著的优点.

关 键 词:[关键词]容量控制通气   压力控制通气   压力控制通气量保证   单肺通气   胸外科

Effects of Different Ventilation Modes on Respiration and Circulation in Elderly Patients Undergoing Thoracic Surgery
Affiliation:(1)Dept. of Anesthesiology,The People’s Hospital of Pu’er City,Pu’er Yunnan 665000;2)Dept. of Anesthesiology,The First People’s Hospital of Yunnan Province,Kunming Yunnan 650032,China)
Abstract:[Abstract]Objective The aim of this study was to explore the effects of volume controlled ventilation (VCV),pressure controlled ventilation(PCV)and pressure controlled ventilation-volume guaranteed (PCV-VG)on respiration and circulation in elderly patients undergoing thoracic surgery. Methods Thirty-six elderly patients who underwent thoracic surgery were enrolled in our study. Patients were divided into VCV, PCV and PCV-VG groups according to randomized design. The hemodynamic and respiratory data and the arterial blood gases had been recorded in the pre-operation,20 min,40 min,60 min after OLV and 20 min after the resumption of two lung ventilation. Results Compared with VCV group,Ppeak value was significantly lower in PCV and PCV-VG groups (P < 0.05), and the difference was not found between the PCV and PCV-VG groups. PaO2 levels in PCV and PCV-VG groups were higher than that in VCV group after the point of OLV+40 (P < 0.05). Comparison of PCV group, PaO2 in PCV-VG group was higher, but did not show a significantly improved during OLV(P > 0.05). Conclusion Compared with VCV, the use of PCV and PCV-VG have significant advantages in the operative oxygenation and airway pressure for elderly patients undergoing OLV.
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