【摘要】：目的:探討在丙泊酚麻醉下呼吸末正壓通氣(PEEP)對腹腔鏡胃癌根治術(shù)患者腦氧代謝的影響。方法:選取本院擇期行腹腔鏡胃癌根治術(shù)患者98例,隨機分為觀察組和對照組,各49例,在丙泊酚麻醉下觀察組采用維持呼吸末正壓通氣PEEP 5cmH_2O,對照組接受常規(guī)通氣PEEP 0cmH_2O。比較術(shù)前與術(shù)后兩組患者腦氧代謝指標(biāo)等。結(jié)果:在建立氣腹前兩組的頸內(nèi)靜脈血氧飽和度(SjvO_2)、動靜脈血氧含量差值(CaO_2-CjvO_2)和腦氧攝取率(CerO_2)比較,差異無統(tǒng)計學(xué)意義(P0.05);建立氣腹1h與2h,觀察組患者三項指標(biāo)均低于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:丙泊酚麻醉下腹腔鏡胃癌根治術(shù)應(yīng)用呼吸末正壓通氣,能降低二氧化碳血癥,改善腦過度灌注狀態(tài),促進腦血流量和腦氧供需平衡,提高預(yù)后效果,改善患者生存質(zhì)量,值得臨床推廣。
[Abstract]:Aim: to investigate the effect of positive end respiratory pressure ventilation (PEEP) under propofol anesthesia on cerebral oxygen metabolism in patients undergoing laparoscopic radical gastrectomy. Methods: 98 patients undergoing laparoscopic radical gastrectomy in our hospital were randomly divided into observation group (n = 49) and control group (n = 49). Under propofol anesthesia, the patients in the observation group were treated with maintaining positive end-respiratory pressure (PEEP) 5 cm H _ (2) O _ (2), and the control group (n = 49). The control group received routine ventilation with PEEP 0 cmH ~ (2) O. The indexes of cerebral oxygen metabolism before and after operation were compared between the two groups. Results: there was no significant difference in internal jugular venous oxygen saturation (SjvO_2), arteriovenous oxygen content difference (CaO_2-CjvO_2) and cerebral oxygen uptake rate (CerO_2) between the two groups before the establishment of pneumoperitoneum (P0.05). When pneumoperitoneum was established for 1 h and 2 h, the three indexes in the observation group were lower than those in the control group, and the difference was statistically significant (P0.05). Conclusion: positive end-respiratory pressure ventilation under propofol anesthesia can reduce carbon dioxide, improve cerebral hyperperfusion, promote the balance of cerebral blood flow and cerebral oxygen supply and demand, improve prognosis and improve the quality of life of patients. It is worthy of clinical popularization.
【作者單位】： 廣西欽州市第一人民醫(yī)院麻醉科二區(qū);
【分類號】：R614;R735.2

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