小潮气量加低水平呼气末正压通气对全身麻醉哮喘患者呼吸功能的影响

目的·探究小潮气量间歇正压通气（IPPV）联合低水平呼气末正压通气（PEEP）对哮喘患者全身麻醉时呼吸功能的影响。方法·选取全身麻醉下行上腹部手术的哮喘患者45例，随机分为3组，每组15例：A组常规潮气量（10mL/kg）IPPV，B组小潮气量（6mL/kg）IPPV，C组小潮气量（6mL/kg）IPPV加低水平PEEP（5cmH2O）。分别记录麻醉诱导后即刻及诱导后5、30、60、120min的气道峰压（Ppeak），并计算肺泡动态顺应性（Cdyn）。监测麻醉诱导前脱氧5min和麻醉诱导后60、120min动脉血气；记录血氧分压（PaO2）和血二氧化碳分压（PaCO2）数值。结果·与A组相比...

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Published in上海交通大学学报（医学版） Vol. 37; no. 10; pp. 1413 - 1416
Main Author 吴雷 夏一梦 范秋维
Format Journal Article
LanguageChinese
Published 河南省许昌市中心医院麻醉科,许昌,461000%上海交通大学医学院附属瑞金医院麻醉科,上海,200025 2017
Subjects
呼气末正压通气
哮喘
小潮气量
间歇正压通气
哮喘
小潮气量
intermittent positive pressure ventilation
positive end expiratory pressure
asthma
呼气末正压通气
low tidal volume
间歇正压通气
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ISSN1674-8115
DOI10.3969/j.issn.1674-8115.2017.10.021

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Summary:目的·探究小潮气量间歇正压通气（IPPV）联合低水平呼气末正压通气（PEEP）对哮喘患者全身麻醉时呼吸功能的影响。方法·选取全身麻醉下行上腹部手术的哮喘患者45例，随机分为3组，每组15例：A组常规潮气量（10mL/kg）IPPV，B组小潮气量（6mL/kg）IPPV，C组小潮气量（6mL/kg）IPPV加低水平PEEP（5cmH2O）。分别记录麻醉诱导后即刻及诱导后5、30、60、120min的气道峰压（Ppeak），并计算肺泡动态顺应性（Cdyn）。监测麻醉诱导前脱氧5min和麻醉诱导后60、120min动脉血气；记录血氧分压（PaO2）和血二氧化碳分压（PaCO2）数值。结果·与A组相比，C组各时段Ppeak均明显降低（P〈0.01），而在麻醉诱导后60、120minCdyn均显著增高（P〈0.05）。与A和B组相比，C组在麻醉诱导后60、120minPaO2也明显升高（P〈0.01）而PaCO2则明显降低（P〈0.05）。结论·对哮喘患者而言，小潮气量联合低水平PEEP模式可降低气道压力，提高肺动态顺应性，改善氧合参数，是一种安全有效的麻醉呼吸管理模式。
Bibliography:WU Lei1, XIA Yi-meng2, FAN Qiu-wei2 （1. Department of Anesthesiology, Xuchang Central Hospital, Xuchang 461000, China; 2. Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China ）
Objective · To investigate the effects of low tidal volume mechanical ventilation and low level of positive end expiratory pressure （PEEP） on respiratory function in patients with asthma under general anesthesia. Methods · Forty-five patients with asthma undergoing upper abdominal surgery under general anesthesia were selected and randomly divided into three groups, with 15 cases in each group. Group A received a regular tidal volume of 10 mL/kg, group B a low tidal volume of 6 mL/kg and group C a low tidal volume of 6 mL/kg combined with 5 cmH2O PEEP. Ppeak was recorded at different time points, including the time of induction under anesthesia and the time of 5, 30 and 60 minutes after anesthesia induction. Based on such parameters, Cdyn were also calculated. Moreover,
ISSN:1674-8115
DOI:10.3969/j.issn.1674-8115.2017.10.021