[1]郑卫雷,王士雷.全身麻醉术中肺保护性通气对肥胖患者肺顺应性及氧合指数的影响[J].医学信息,2019,32(24):60-62.[doi:10.3969/j.issn.1006-1959.2019.24.019]
　ZHENG Wei-lei,WANG Shi-lei.Effect of Lung Protective Ventilation on General Lung Compliance and Oxygenation Index in Obese Patients[J].Medical Information,2019,32(24):60-62.[doi:10.3969/j.issn.1006-1959.2019.24.019]
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全身麻醉术中肺保护性通气对肥胖患者肺顺应性及氧合指数的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年24期
页码:
60-62
栏目:
论著
出版日期:
2019-12-15

文章信息/Info

Title:
Effect of Lung Protective Ventilation on General Lung Compliance and Oxygenation Index in Obese Patients
文章编号:
1006-1959（2019）24-0060-03
作者:
郑卫雷1; 王士雷2
（1.青岛大学医学院第二附属医院麻醉科，山东 青岛 266011；2.青岛大学附属医院麻醉科，山东 青岛 266555）
Author(s):
ZHENG Wei-lei1; WANG Shi-lei2
(1.Department of Anesthesiology,the Second Affiliated Hospital of Qingdao University Medical College,Qingdao 266011,Shandong,China;2.Department of Anesthesiology,Affiliated Hospital of Qingdao University,Qingdao 266555, Shandong,China)
关键词:
肥胖; 腹腔镜手术; 全身麻醉; 肺保护性通气; 肺顺应性; 氧合指数
Keywords:
Obesity; Laparoscopic surgery; General anesthesia; Protective lung ventilation; Lung compliance; Oxygenation index
分类号:
R614.2
DOI:
10.3969/j.issn.1006-1959.2019.24.019
文献标志码:
A
摘要:
目的 观察全身麻醉术中肺保护性通气（LPVS）对肥胖患者肺顺应性及氧合指数（OI）的影响。方法 选择2016年10月~2019年8月于我院择期行全身麻醉下腹腔镜手术的68例肥胖患者，随机分为对照组与观察组，各34例。对照组接受常规模式机械通气，观察组实施LPVS策略。比较气管插管后10 min（T1）、手术开始后60 min（T2）两组肺顺应性（CL）及氧合功能、血压（DBP、SBP）、心率（HR）及术前术后肺功能。结果 T1时两组CL、OI、PaO2比较，差异无统计学意义（P＞0.05）；T2时观察组CL、OI、PaO2分别为（288.49±30.18）ml/cmH2O、（40.53±8.14）、（422.19±57.40）mmHg，均高于对照组的（221.54±28.67）ml/cmH2O、（31.68±6.70）、（331.74±36.59）mmHg，差异有统计学意义（P＜0.05）；T2时两组DBP、SBP、HR比较，差异无统计学意义（P＞0.05）；手术后观察组FEV1、FVC、FEV1/FVC分别为（1.37±0.43）L、（1.68±0.63）L、（81.29±11.76）%，均高于对照组的（1.06±0.32）L、（1.39±0.47）L、（74.83±12.50）%，差异有统计学意义（P＜0.05）。结论 肥胖患者腹腔镜手术全身麻醉时进行肺保护性通气可降低患者肺泡塌陷，改善氧合功能，增加肺顺应性，有助于保护肺功能，且对循环系统影响较小。
Abstract:
Objective To observe the effects of lung protective ventilation (LPVS) on lung compliance and oxygenation index (OI) in obese patients during general anesthesia. Methods 68 obese patients who underwent laparoscopic surgery under general anesthesia in our hospital from October 2016 to August 2019 were randomly divided into a control group and an observation group, each with 34 cases. The control group received conventional mode mechanical ventilation, and the observation group implemented the LPVS strategy. Lung compliance (CL) and oxygenation function, blood pressure (DBP, SBP), heart rate (HR), and postoperative lung function were compared between the two groups 10 min(T1) after tracheal intubation and 60 min(T2) after the start of surgery.Results There was no significant difference in CL, OI, and PaO2 between the two groups at T1 (P> 0.05); CL, OI, and PaO2 at the T2 observation group were(288.49±30.18) ml/cmH2O, (40.53±8.14), (422.19±57.40)mmHg, higher than (221.54±28.67) ml/cmH2O, (31.68±6.70), (331.74±36.59) mmHg in the control group, the difference was statistically significant (P<0.05);There was no significant difference in DBP, SBP, and HR between the two groups at T2(P>0.05); FEV1, FVC, FEV1/FVC in the observation group after surgery were (1.37±0.43) L, (1.68±0.63)L, (81.29±11.76)%, which were higher than (1.06±0.32) L, (1.39±0.47) L, and (74.83±12.50)% of the control group,the difference was statistically significant (P<0.05). Conclusion Lung protective ventilation during laparoscopic general anesthesia in obese patients can reduce alveolar collapse, improve oxygenation function, increase lung compliance, help protect lung function, and have less impact on the circulatory system.

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更新日期/Last Update: 2019-12-15