摘要
目的 观察肺萎陷对机械通气患者锁骨下静脉与胸膜距离的影响.方法 2018年1月至2月接受择期全身麻醉患者30例.年龄20~60岁,ASAI或II级.患者麻醉诱导行机械通气(潮气量8 ml/kg)5min后,以随机顺序先后于机械通气(C组)和肺萎陷(N组)状态下接受锁骨下静脉(SCV)超声检查,记录SCV与胸膜的垂直距离(Dscv-pleura),脉搏氧饱和度(SpO2)和呼气末二氧化碳(PETCO2).定义Dscv-pleura改变>15%为有临床意义.结果 与C组比较,N组患者Dscv-pleura显著增加(t=3.956,P<0.001),增加幅度为10.3%.与C组比较,N组患者SpO2显著降低(t=5.653,P<0.001),PETCO2显著升高(t=12.75,P<0.001).结论 对于8ml/kg潮气量行机械通气患者,肺萎陷增加锁骨下静脉与胸膜间距,但增加幅度并无临床意义.
Objective To explore the effect of lung deflation on the distance from the subclavian vein(SCV)to the pleura(Dscv-pleura)in mechanically ventilated patients. Methods 30 patients underwent elective operation under general anaesthesia at Yinzhou Hospital Affiliated to Medical School of Ningbo University from January to February 2018,ASA I or II grade,aged 20~60,were enrolled in this study. Mechanical ventilation (tidal volume=8ml/kg)was started following general anaesthesia and all the patients were received the lung deflation(group N)and normal ventilation (group C). The SCV was investigated by ultrasonography. The Dscv-pleura was measured after applying 2 maneuvers respectively. It is clinically useful to define Dscv-pleura change>15%. The saturation of pulse oximetry(SpO2)and end-tidal CO2 partial pressure(PETCO2)were recorded. Results Compared to group C,the Dscv-pleura of group N significantly increased by 10.3%(t=3.956,P<0.001). Compared to group C,SpO2 of group N decreased(t=5.653,P<0.001)and PETCO2 of group N increased(t=12.75,P<0.001). Conclusion While not clinically useful,the lung deflation increases the distance from the SCV to the pleura in mechanically ventilated patients with tidal volume set at 8 ml/kg.
出处
《浙江临床医学》
2019年第3期403-404,共2页
Zhejiang Clinical Medical Journal
关键词
锁骨下静脉
胸膜
肺萎陷
超声检查
Subclavian vein
Pleura
Lung deflation
Ultrasonography
