不同通气模式对老年胸科手术患者呼吸和循环的影响

［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．

Effects of Different Ventilation Modes on Respiration and Circulation in Elderly Patients Undergoing Thoracic Surgery

［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.