摘要
目的分析胸腔镜下肺癌手术时单肺通气的临床麻醉效果。方法回顾分析2018年9月~2019年8月在我院治疗的60例肺癌患者临床资料,患者均在胸腔镜下手术,采用静脉快速诱导插入双腔支气管导管,在麻醉诱导后进行间歇性正压通气(IPPV),在单肺通气过程中采用间歇性IPPV或萎缩肺持续正压通气,并相应的调整呼吸参数。比较不同时间(麻醉前、双肺IPPV、单肺的IPPV 30 min、IPPV 60 min、IPPV 90 min、双肺IPPV 15 min)血压(MAP)、心率(HR)以及动脉血气指标。结果麻醉前、双肺IPPV、单肺的IPPV 30 min、IPPV 60 min、IPPV 90 min、双肺IPPV 15 min时间段MAP、HR比较,差异无统计学意义(P>0.05),而在动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、呼末二氧化碳分压(PETCO2)比较,差异有统计学意义(P<0.05);双肺IPPV与单肺IPPV在鼻导管吸氧(FiO2)、TV比较,差异有统计学意义(P<0.05)。结论单肺通气可使胸腔镜下肺癌手术患侧肺萎缩满意,在PaO2下降的情况下可有效维持呼吸正常,促进手术的顺利进行。
Objective To analyze the clinical anesthetic effect of single lung ventilation during thoracoscopy lung cancer surgery.Methods The clinical data of 60 patients with lung cancer treated in our hospital from September 2018 to August 2019 were retrospectively analyzed.All patients underwent thoracoscopy surgery,and a double-lumen bronchial catheter was quickly induced by intravenous infusion.Intermittent positive pressure was performed after induction of anesthesia.Ventilation(IPPV),intermittent IPPV or atrophic lung continuous positive pressure ventilation during single-lung ventilation,and adjust breathing parameters accordingly.Compare blood pressure(MAP),heart rate(HR),and arterial blood gas indicators at different times(pre-anesthesia,IPPV in both lungs,IPPV in one lung 30 min,IPPV 60 min,IPPV 90 min,IPPV 15 min in both lungs).Results Before anesthesia,IPPV in both lungs,IPPV in single lungs for 30 min,IPPV 60 min,IPPV 90 min,and IPPV in both lungs 15 min,the MAP and HR comparisons were not statistically significant(P>0.05).The comparison of partial pressure(PaO2),partial pressure of carbon dioxide(PaCO2),and partial pressure of exhaled carbon dioxide(PETCO2)was statistically significant(P<0.05);IPPV in two lungs and IPPV in single lungs received(FiO2),TV comparison,the difference was statistically significant(P<0.05).Conclusion One-lung ventilation can satisfy the lung atrophy of the affected side of thoracoscopy lung cancer surgery,and it can effectively maintain normal breathing with the decrease of PaO2 and promote the smooth operation.
作者
王彬彬
WANG Bin-bin(Department of Anesthesiology,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,China)
出处
《医学信息》
2019年第24期113-114,共2页
Journal of Medical Information
关键词
胸腔镜
肺癌
单肺通气
麻醉
Thoracoscopy
Lung cancer
Single lung ventilation
Anesthesia
