摘要
目的探讨全麻诱导期呼气末正压通气(PEEP)对腹腔镜胆囊切除术患者围术期呼吸功能的影响。方法选择2016年1月-2018年6月在我院行腹腔镜胆囊切除术治疗的160例患者,随机分为对照组和观察组,每组各80例。两组患者均采用气管插管全身麻醉,对照组患者在术中采用PEEP,观察组患者在全麻诱导期就给予PEEP,比较两组患者在气腹完成时(T0)、气腹30min(T1)、气腹60min(T2)、气腹90min(T3)、放气时(T4)等不同时间的动脉与呼气末二氧化碳分压差值、肺泡动态顺应性及氧合指数。结果观察组患者的动脉与呼气末二氧化碳分压差值、肺泡动态顺应性在T1、T2、T3、T4时刻均显著高于对照组(P<0.05);观察组患者的氧合指数在T2、T3、T4时刻显著高于对照组(P<0.05)。结论全麻腹腔镜胆囊切除术患者在麻醉诱导期给予PEEP,能够有效预防患者发生低和高二氧化碳血症,改善患者的肺顺应性和氧合功能,保障患者呼吸功能的稳定。
Objective To investigate the effect of general anesthesia induction of positive end-expiratory pressure ventilation on perioperative respiratory function in patients undergoing laparoscopic cholecystectomy.Methods 160 patients who underwent laparoscopic cholecystectomy in our hospital from January to February 2018 were randomly divided into the control group and the observation group,with 80 cases in each group.Both groups were treated with general anesthesia with tracheal intubation.The control group was treated with PEEP,and the observation group was given PEEP during the induction period of general anesthesia.The difference between arterial and end-tidal carbon dioxide partial pressure were compared at pneumoperitoneum completion (T0),pneumoperitoneum for 30 minutes (T1),pneumoperitoneum for 60 minutes (T2),pneumoperitoneum for 90 minutes (T3),and deflation (T4) between the two groups.Results The difference in arterial and end-tidal carbon dioxide pressure and alveolar dynamic compliance in the observation group were significantly higher than those in the control group at T1,T2,T3,and T4 ( P< 0.05).The oxygenation index of the observation group was significantly higher in the observation group than in the control group at T2,T3 and T4 ( P< 0.05).Conclusion PEEP in patients undergoing general anesthesia laparoscopic cholecystectomy can prevent low and hypercapnia,improve lung compliance and oxygenation,and ensure the stability of respiratory function.
作者
高民强
王巍
丁汉琳
GAO Min-qiang;WANG Wei;DING Han-lin(Xishui Hospital Affiliated to Hubei Institute of Science and Technology,Xishui,Hubei 438200,China)
出处
《临床肺科杂志》
2019年第8期1414-1417,共4页
Journal of Clinical Pulmonary Medicine
关键词
全麻诱导期
呼气末正压通气
腹腔镜
呼吸功能
general anesthesia induction
end-expiratory positive pressure ventilation
laparoscopic surgery
respiratory function
