摘要
目的:探讨不同温湿度二氧化碳对食管癌胸腔镜手术患者血流动力学、肺内分流率及氧合指数的影响。方法:选择2017年3月至2021年9月在南阳医学高等专科学校第一附属医院行胸腔镜食管癌根治术的患者92例进行研究,采用随机数字表法将患者分为两组,每组各46例。两组患者均由同一组医护人员行胸腔镜食管癌根治术,对照组在常规二氧化碳人工气胸下进行手术,观察组行加温湿化二氧化碳人工气胸。比较两组患者手术一般情况、血流动力学、肺内分流率及氧合指数。结果:两组患者术中出血量、手术时间及术前体温比较,差异均无统计学意义(P>0.05),观察组术后体温明显高于对照组,差异具有统计学意义(P<0.05)。对照组术后心输出量、每搏输出量及平均动脉压均较术前明显上升,差异具有统计学意义(P<0.05),观察组手术前后心输出量、每搏输出量及平均动脉压的差异均无统计学意义(P>0.05)。两组患者术后氧合指数均较术前明显升高,但观察组升高幅度更大,两组患者肺内分流率均较术前明显下降,但观察组下降更明显,差异均具有统计学意义(P<0.05)。结论:食管癌患者在加温湿化二氧化碳人工气胸下行胸腔镜食管癌根治术,较常规二氧化碳人工气胸可明显减少患者血流动力学参数波动,稳定术后体温、提高氧合指数,降低肺内分流率。
Objective To investigate the effects of different temperature and humidity carbon dioxide on hemodynamics,intrapulmonary shunt rate and oxygenation index in patients with esophageal cancer undergoing thoracoscopy.Methods A total of 92 patients who underwent thoracoscopic radical resection of esophageal cancer in the First Affiliated Hospital of Nanyang Medical College from March 2017 to September 2021 were selected for this study.The patients were divided into two groups by random number table method,with 46 patients in each group.Patients in both groups received thoracoscopic radical resection of esophageal cancer by the same group of medical staff.The control group received conventional carbon dioxide artificial pneumothorax,and the observation group received humidified carbon dioxide artificial pneumothorax with heating.The general operation conditions,hemodynamics,intrapulmonary diversion rate and oxygenation index were compared between the two groups.Results There was no significant difference in intraoperative blood loss,operation time and preoperative body temperature between the two groups (P > 0.05),and the postoperative body temperature of the observation group was significantly higher than that of the control group,the difference was statistically significant (P < 0.05).After operation,cardiac output,stroke output and mean arterial pressure in the control group increased significantly,with statistically significant differences (P < 0.05),there was no statistically significant difference in cardiac output,stroke output and mean arterial pressure in the observation group before and after operation (P > 0.05).The oxygenation index in both groups increased significantly after operation compared with before operation,but the increase was greater in the observation group,and the pulmonary diversion rate in the two groups decreased significantly compared with before operation,but the decrease was more significant in the observation group,with statistical significance (P < 0.05).Conclusion Compared with conven
作者
杜海侠
黄国胜
DU Hai-xia;HUANG Guo-sheng(The First Affiliated Hospital of Nanyang Medical College,Henan Nanyang 473000)
出处
《深圳中西医结合杂志》
2022年第9期77-80,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
食管癌
胸腔镜
二氧化碳温湿度
人工气胸
Esophagus cancer
Thoracoscope
Carbon dioxide temperature and humidity
Piezotherapy
