摘要
目的探讨胸科手术术前雾化吸入沙丁胺醇对术中肺功能及术后并发症的影响。方法选取择期行肺叶/肺段切除患者100例,随机分为对照组和试验组,每组50例。剔除术中因失血超过400 mL(对照组2例,试验组2例)及单肺通气时长不满30 min(对照组2例,试验组5例)的患者后,实际纳入统计的人数为对照组46例和试验组43例。试验组于麻醉诱导开始前30 min雾化吸入沙丁胺醇5 mg,对照组直接进行麻醉诱导。分别于麻醉诱导前(T1)、气管插管后(T2)、单肺通气30 min后(T3)、手术结束时(T4)经桡动脉抽取动脉血行血气分析。患者出院后通过电子病历系统记录术后胸腔引流瓶拔除时间及总住院费用。结果两组T2、T3、T4时刻平均动脉压均低于T1时刻(P<0.05);T3时刻的氧合指数低于T1、T2、T4时刻(P<0.05);T3时刻的气道峰压(p_(peak))高于T2、T4时刻(P<0.05)。试验组的心率在各时刻均高于对照组(P<0.05),T2时刻的p_(peak)低于对照组(P<0.05),T3时刻的氧合指数高于对照组(P<0.05)。两组患者住院期间术后并发症的发生及住院花费差异无统计学意义(P>0.05)。结论在胸科手术术前给予患者雾化吸入沙丁胺醇,可以降低插管后气道阻力,改善氧合功能,有助于改善患者围手术期的肺功能。
Objective To investigate the effect of preoperative nebulized salbutamol on intraoperative pulmonary function and postoperative complications in thoracic surgery.Methods One hundred patients undergoing elective lobectomy/segmental pneumonectomy were randomly divided into control group(n=50)and experimental group(n=50).After excluding patients with intraoperative blood loss of more than 400 mL(2 cases in the control group and 2 cases in the experimental group)and one-lung ventilation duration less than 30 min(2 cases in the control group and 5 cases in the experimental group),46 cases in the control group and 43 cases in the experimental group were actually included in the statistics.The experimental group nebulized 5 mg salbutamol 30 min before anesthesia induction,while the control group received anesthesia induction directly.Arterial blood was drawn from radial artery for blood gas analysis before anesthesia induction(T1),after endotracheal intubation(T2),30 min after one-lung ventilation(T3)and end of operation(T4).After discharge,the removal time of postoperative chest drainage bottle and total hospitalization expenses were recorded by electronic medical records.Results In the two groups,the mean arterial pressure at T2,T3 and T4 was lower than that at T1(P<0.05),the oxygenation index at T3 was lower than that at T1,T2 and T4(P<0.05),and the p_(peak) at T3 was higher than that at T2 and T4(P<0.05).Compared with control group,the heart rate of experimental group was higher at all times(P<0.05),the p_(peak) of experimental group at T2 was lower(P<0.05),and the oxygenation index of experimental group at T3 was higher(P<0.05).There was no significant difference in postoperative complications and hospitalization expenses between the two groups(P>0.05).Conclusion Nebulized salbutamol before chest surgery can reduce airway resistance and improve oxygenation function after intubation,and contribute to improve lung function during perioperative period.
作者
仇庆亚
魏顺民
井紫薇
吕苗苗
陈志阳
李江静
张霞婧
高昌俊
孙绪德
QIU Qingya;WEI Shunmin;JING Ziwei;LYU Miaomiao;CHEN Zhiyang;LI Jiangjing;ZHANG Xiajing;GAO Changjun;SUN Xude(Department of Anesthesiology,Tangdu Hospital,Air Force Medical University,Xi an 710038,China;Department of Anesthesiology,Xijing 986 Hospital,Air Force Medical University,Xi an 710054,China)
出处
《空军军医大学学报》
CAS
2022年第6期725-728,733,共5页
Journal of Air Force Medical University
基金
国家自然科学基金(31570845)
陕西省重点研发计划项目(2022SF-189)
陕西省自然科学基金(S2019-JC-YB-0553)。
关键词
单肺通气
沙丁胺醇
雾化
氧合
肺部并发症
one-lung ventilation
salbutamol
nebulization
oxygenation
pulmonary complications
