本文關(guān)鍵詞： 肺保護(hù) 肺部并發(fā)癥 機械通氣　出處：《上海交通大學(xué)學(xué)報(醫(yī)學(xué)版)》2015年11期 　論文類型：期刊論文

【摘要】：目的探討肺保護(hù)通氣策略對術(shù)后肺部并發(fā)癥高危全身麻醉手術(shù)患者呼吸力學(xué)和肺氧合功能的影響。方法選取120例術(shù)后肺部并發(fā)癥高危的全身麻醉手術(shù)患者,隨機分為研究組(n=60):潮氣量6.00 m L/kg,呼吸頻率15次/min,呼氣末正壓6 cm H2O,吸呼比1∶1.5,手術(shù)開始后每小時行1次肺復(fù)張,設(shè)定為自主呼吸模式,壓力限定30 cm H2O,持續(xù)30 s,然后恢復(fù)至原有通氣模式;對照組(n=60):潮氣量10.00 m L/kg,呼吸頻率12次/min,呼氣末正壓0 cm H2O,吸呼比1∶1.5。兩組分別于機械通氣30 min(T1)以及手術(shù)結(jié)束(T2)時采取動脈血測血氣分析,根據(jù)結(jié)果記錄氧分壓、潮氣量、氣道峰壓和平臺壓,計算氧合指數(shù)、肺靜態(tài)順應(yīng)性和肺動態(tài)順應(yīng)性。結(jié)果研究組中T2時間段的平臺壓值明顯低于對照組,肺靜態(tài)順應(yīng)性和氧合指數(shù)高于對照組,術(shù)后肺部并發(fā)癥發(fā)生率明顯少于對照組。研究組在ICU治療天數(shù)少于對照組(P0.05)。結(jié)論肺保護(hù)通氣策略能夠增加肺部順應(yīng)性,增加肺氧合功能,減少術(shù)后肺部并發(fā)癥。
[Abstract]:Objective to investigate the effects of lung protective ventilation strategy on high risk of postoperative pulmonary complications of general anesthesia in patients with respiratory mechanics and oxygenation function. Methods 120 cases of postoperative pulmonary complications in high-risk patients with general anesthesia, were randomly divided into study group (n=60): m L/ kg 6 tidal volume, respiratory rate 15 /min, exhale at the end of the positive pressure of 6 cm H2O, respiratory ratio of 1 to 1.5 for every 1 hours after the start of surgery for pulmonary reexpansion, setting independent breathing patterns, pressure is limited to 30 cm H2O for 30 s, and then return to the original ventilation mode; the control group (n=60): 10 m L/kg tidal volume, respiratory rate 12 /min, 0 cm H2O positive end expiratory pressure, breath ratio of 1: 1.5. two group were 30 min mechanical ventilation (T1) and the end of operation (T2) to measure arterial blood gas analysis, according to the records of the results of oxygen partial pressure, tidal volume, peak airway pressure and platform pressure, oxygenation index calculation, the static lung compliance and lung Dynamic compliance. Results T2 time period in the study group platform pressure value was significantly lower than the control group, static lung compliance and oxygenation index higher than the control group, the incidence of postoperative pulmonary complications was significantly less than the control group. The study group were less than the control group in the treatment of ICU (P0.05). Conclusion lung protective ventilation strategy can increase lung compliance, increase oxygenation, reduce postoperative pulmonary complications.

【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院北院麻醉科;上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院麻醉科;
【分類號】：R614.2
【正文快照】： 肺保護(hù)通氣策略在急性呼吸窘迫綜合征患者可以減輕或者防止機械性肺損傷,而對于全身麻醉(簡稱全麻)手術(shù)患者圍手術(shù)期應(yīng)用是否具有肺保護(hù)作用,減少術(shù)后肺部并發(fā)癥還有待研究。本研究選擇術(shù)后易感肺部并發(fā)癥全麻手術(shù)患者,采用常規(guī)通氣與保護(hù)性通氣進(jìn)行比較,以探討肺保護(hù)通氣策略

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