【摘要】：目的：比較單肺通氣（One-lung ventilation, OLV）時(shí)高頻振蕩通氣（High-frequencyoscillatory ventilation, HFOV）和常規(guī)機(jī)械通氣（Conventional mechanical ventilation,CMV）對(duì)肺氧合的影響，探討在OLV中HFOV的可行性。 方法：通過(guò)自身對(duì)照研究，收集符合標(biāo)準(zhǔn)的擇期胸外科手術(shù)的患者10例，手術(shù)麻醉誘導(dǎo)插入雙腔支氣管后(予右側(cè)臥位，通氣肺為右肺)，首先予常規(guī)單肺通氣20min，然后進(jìn)行高頻振蕩通氣20min，再改為常規(guī)單肺通氣20min。分別記錄兩種通氣模式下5min(T1)、10min(T2)、15min(T3)、20min(T4)時(shí)的脈氧、血壓、心率，然后于20min時(shí)抽取橈動(dòng)脈血行血?dú)夥治�，記錄PaO2、PaCO2、pH、SaO2等指標(biāo)。 結(jié)果：當(dāng)從HFOV改為CMV后，動(dòng)脈氧分壓從（210.90±124.19）mmHg下降到（162.80±102.83）mmHg，，P=0.0230.05，差異具有統(tǒng)計(jì)學(xué)意義；同時(shí)，動(dòng)脈二氧化碳分壓從（60.00±9.04）mmHg下降至（52.60±12.30）mmHg，P=0.0450.05，差異具有統(tǒng)計(jì)學(xué)意義；兩種通氣方式PaO2/FiO（2P=0.241）、pH（P=0.286）及SaO（2P=0.173）差異分析無(wú)統(tǒng)計(jì)學(xué)意義。兩種通氣方式血壓、心率比較無(wú)明顯差異（P0.05）。 結(jié)論：在單肺通氣中，應(yīng)用HFOV的氧合表現(xiàn)出優(yōu)于常規(guī)容量機(jī)械通氣模式；同時(shí)HFOV在單肺通氣中與CMV相比對(duì)血流動(dòng)力學(xué)無(wú)明顯影響。
[Abstract]:Objective: to compare the effects of high frequency oscillatory ventilation (High-frequencyoscillatory ventilation, HFOV) and conventional mechanical ventilation (Conventional mechanical ventilation,CMV) on pulmonary oxygenation during single lung ventilation (One-lung ventilation, OLV) and to explore the feasibility of HFOV in OLV. Methods: a self-controlled study was conducted in 10 patients undergoing elective thoracic surgery according to the criteria. Anesthesia induction was performed after insertion into the double-lumen bronchus (right lateral position). One lung was ventilated for 20 minutes, then the high frequency oscillatory ventilation was performed for 20 minutes, and then the routine single lung ventilation for 20 minutes. Pulse oxygen, blood pressure and heart rate were recorded at 5min (T 1) 10 min (T 2) and 15 min (T 3) and 20 min (T 4) under two ventilation modes respectively. Radial artery blood was extracted at 20min for blood gas analysis and PaO2,PaCO2,pH,SaO2 was recorded. Results: after changing from HFOV to CMV, the arterial partial pressure of oxygen decreased from (210.90 鹵124.19) mmHg to (162.80 鹵102.83) mmHg,P=0.0230.05, and the arterial partial pressure of carbon dioxide decreased from (60.00 鹵9.04) mmHg to (52.60 鹵12.30) mmHg,P=0.0450.05,. There was no significant difference between PaO2/FiO (2P=0.241) and SaO (2P=0.173) in pH (P0. 286) and SaO (2P=0.173). There was no significant difference in blood pressure and heart rate between the two ventilation modes (P0.05). Conclusion: the oxygenation of HFOV in single lung ventilation is superior to that of conventional volume mechanical ventilation, and HFOV has no significant effect on hemodynamics compared with that of CMV in single lung ventilation.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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相關(guān)期刊論文 前1條

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