發(fā)布時間：2018-05-09 09:48

  本文選題：腹腔鏡手術 + 呼吸力學　； 參考：《臨床麻醉學雜志》2015年07期

【摘要】：目的觀察腹腔鏡結直腸手術患者麻醉手術期間不同通氣模式對患者呼吸功能的影響。方法選擇擬行腹腔鏡結直腸癌根治術患者60例,均分為肺復張組(RM組)和常規(guī)通氣策略組(C組)。在麻醉誘導前(T1)、麻醉誘導后插管前(T2)、氣管插管后即刻(T3)、切皮前即氣腹前(T4)、氣腹30min(T5)、60min(T6)、90min(T7)、120min(T8)、縫合切口時(T9)及術畢(T10)時監(jiān)測肺順應性(Comp)、PaO2、PaCO2的變化。結果與T4時比較,T5~T8時兩組Comp均明顯降低(P0.01),而T9時RM組Comp明顯降低,C組明顯降低(P0.01);與T4時比較,T8時RM組PaO2、PaCO2明顯升高(P0.01);C組PaO2明顯降低,但PaCO2明顯升高(P0.01);且T8時RM組PaO2、PaCO2均明顯高于C組(P0.01)。結論腹腔鏡結直腸手術中采用小潮氣量合并肺復張的通氣策略有利于增加肺順應性和氧合作用。
[Abstract]:Objective to observe the effect of different ventilation modes on respiratory function in patients undergoing laparoscopic colorectal surgery. Methods A total of 60 patients undergoing laparoscopic radical resection of colorectal cancer were divided into two groups: lung reopening group (RM group) and routine ventilation strategy group (group C). Before anesthesia induction, before intubation, immediately after tracheal intubation, before tracheal intubation, immediately after endotracheal intubation, immediately after tracheal intubation, before pneumoperitoneum T4, 30 mins before pneumoperitoneum, 90 min after pneumoperitoneum, 90 min T7, 120 min T8, at the time of suture, T9) and at the end of operation T10), the changes of Paco _ 2 and Paco _ 2 were monitored. Results compared with T4, the Comp of both groups was significantly lower than that of T4, while the Comp of RM group was significantly lower than that of T9 group, and that of P0.01T group was significantly decreased in T9 group, and that of Pao _ 2PCO _ 2 of RM group was significantly higher than that of T _ 4 group at T _ 4, and the PaO2 of RM group was significantly lower than that of T _ (8) group. However, PaCO2 was significantly higher than that in group C (P 0.01), and Pao 2 CO 2 in RM group was significantly higher than that in C group at T 8. Conclusion the ventilation strategy of low tidal volume combined with pulmonary retension is beneficial to increase lung compliance and oxygen use in laparoscopic colorectal surgery.
【作者單位】： 廣州中醫(yī)藥大學第二附屬醫(yī)院麻醉科;廣東省佛山市第一人民醫(yī)院麻醉科;
【分類號】：R614

【參考文獻】

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1 江飛;金孝\，

本文編號：1865549