摘要
目的比较压力控制容量保证通气(PCV-VG)和容量控制通气(VCV)对腹腔镜结肠癌根治术老年患者炎性因子、呼吸循环的影响。方法选取50例择期行腹腔镜结肠癌根治术的老年患者为研究对象,分为VCV组和PCV-VG组,每组25例。记录插管后气腹前10 min(T1)、气腹后40 min(T2)、气腹后80 min(T3)、气腹停止后20 min(T4)时心率(HR)、平均动脉压(MAP)、峰值气道压(Ppeak)、平均气道压(Pmean)、动态肺顺应性(Cdyn)、呼气末二氧化碳分压(PETCO2)。T1~T4时检测动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)进行动脉血气分析,T1~T3时采集静脉血,检测白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果两组患者各时间段HR无明显改变(P>0.05);与T1比较,T2~T3时两组患者MAP、Ppeak、Pmean、PETCO2、PaCO2明显升高,Cdyn明显降低,差异有统计学意义(P<0.05)。与VCV组比较,T2~T3时PCV-VG组患者的Ppeak、Pmean、IL-6和TNF-α降低,Cdyn升高,差异有统计学意义(P<0.05)。结论PCV-VG在降低气道压力,增加肺顺应性,减少炎性反应等多方面优于VCV,更适合用于腹腔镜结肠癌根治老年患者。
Objective To compare the effects of pressure-controlled volume-guaranteed ventilation mode(PCV-VG)and volume-controlled ventilation mode(VCV)on inflammatory factors and respiratory circulation in elderly patients undergoing laparoscopic radical resection of colon cancer.Methods A total of 50 elderly patients with elective laparoscopic radical resection of colon cancer were selected and divided into the VCV group and the PCV-VG group,with 25 patients in each group.Heart rate(HR),mean arterial pressure(MAP),peak airway pressure(Ppeak)and mean airway pressure(Pmean),dynamic lung compliance(Cdyn),end-expiratory partial pressure of carbon dioxide(PETCO2)at 10 minutes before pneumoperitoneum(T1),40 minutes after pneumoperitoneum(T2),80 minutes after pneumoperitoneum(T3),20 minutes after pneumoperitoneum stop(T4)were recorded after intubation.Arterial blood gas analysis was performed to detect arterial oxygen partial pressure(PaO2)and arterial carbon dioxide partial pressure(PaCO2)at T1-T4.Venous blood was collected at T1-T3 for detecting the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Results There was no significant change in HR between the two groups at each time period(P>0.05).Compared with T1,MAP,Ppeak,Pmean,PETCO2 and PaCO2 significantly increased at T2-T3,while Cdyn significantly decreased,the differences were statistically significant(P<0.05).Compared with the VCV group,Ppeak,Pmean,IL-6 and TNF-αdecreased,Cdyn increased in the PCV-VG group at T2-T3(P<0.05).Conclusion PCV-VG is superior to VCV in reducing airway pressure,increasing lung compliance and reducing inflammatory response,and it is more suitable for laparoscopic radical treatment of elderly patients with colon cancer.
作者
宋雪松
王昊
康建勋
SONG Xuesong;WANG Hao;KANG Jianxun(Graduate School,Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Department of Anesthesiology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Department of Anesthesiology,Chaoyang Central Hospital,Chaoyang,Liaoning 122000,China)
出处
《重庆医学》
CAS
2020年第11期1774-1777,1781,共5页
Chongqing medicine
关键词
压力控制容量保证通气模式
腹腔镜检查
结肠肿瘤
呼吸力学
炎性因子
pressure-controllde ventilation-volume guaranteed
laparoscopy
colonic neoplasms
breathing mechanics
inflammatory factor
