术前MVV对脊柱矫形手术患者围手术期肺功能及愈后的影响

目的探讨术前分钟最大通气量（MVV）对行脊柱矫形手术的患者围手术期肺功能及愈后的影响。方法选取我院2019年6月至2020年6月收治的60例脊柱矫形手术患者,按术前肺功能MVV占预计值百分比进行分组,MVV>50%预计值为正常组（A组）,30%

Effect of Preoperative MVV on Perioperative Lung Function and Prognosis in Patients Undergoing Spinal Orthopedic Surgery.

Objective To investigate effects of preoperative maximum minute ventilation volume(MVV)onperioperativelung function and prognosisof patients undergoing spinal orthopedic surgery.Methods From June 2019 to June 2020, 60 patients undergoing spinal orthopedic surgery in our hospitalwere selected and divided into groups according to percentage of perioperative lung function MVV to predicted value. The predicted value of MVV>50% was normal group(group A), 30 % < MVV<50%was moderately impaired lung function group( group B). All patients underwent anesthesia combined intravenous injection with in-halation. Arterial oxygen partial pressure( PaO₂) , carbon dioxide partial pressure( PaO₂) , oxygenation index( OI) , airway plat-eau pressure( Pplat ) and airway resistance( AR ) were observed at 4 time points , including before operation( T0), 1h(T1), 2h( T2)and end of operation( T3). After operation, thosevalues were recorded , including probability of being transferred to ICU,spontaneous breathing recovery time, post-operative tube time, PaO₂, at 3rd day(t1 ) and 7th day( t2 ) after operation, IL-6, PCTand CRP. Results PaO₂, and OI of two groups at Tl, T2, and T3 were significantly lower than To, and airway plateau pressureand airway resistance were significantly increased. At T2 and T3, the airway plateau pressure and airway resistance of group Awere significantly lower than those of group B, and PaO₂, and OI were significantly higher than those of group B with statisticallysignificantdifference(P <0.05). Recovery time of spontaneous breathing and postoperative extubation in group B were longer thanthose in group A with statistically significant difference( P<0.05). There were statistically significant differences in PaO₂, and OIat tl. PaO₂, and OI in group B were lower than those in group A. There was no significant difference in PaO₂, and inflammatory fac-tors at t2. ConclusionFor patients undergoing spinal orthopedic surgery , preoperative MVV could predict lung function and post-operative resuscitation time. Moderate lung function impairment would not affect long-term prognosis.