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    张敏. 肺保护性通气联合肺复张对全麻开腹手术病人围手术期肺功能和氧分压的影响[J]. 蚌埠医科大学学报, 2019, 44(6): 738-741. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.011
    引用本文: 张敏. 肺保护性通气联合肺复张对全麻开腹手术病人围手术期肺功能和氧分压的影响[J]. 蚌埠医科大学学报, 2019, 44(6): 738-741. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.011
    shu
    ZHANG Min. Effect of pulmonary protective ventilation combined with pulmonary reextension on pulmonary function and oxygen partial pressure in perioperative patients treated with laparotomy under general anesthesia[J]. Journal of Bengbu Medical University, 2019, 44(6): 738-741. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.011
    Citation: ZHANG Min. Effect of pulmonary protective ventilation combined with pulmonary reextension on pulmonary function and oxygen partial pressure in perioperative patients treated with laparotomy under general anesthesia[J]. Journal of Bengbu Medical University, 2019, 44(6): 738-741. DOI: 10.13898/j.cnki.issn.1000-2200.2019.06.011
    shu

    肺保护性通气联合肺复张对全麻开腹手术病人围手术期肺功能和氧分压的影响

    Effect of pulmonary protective ventilation combined with pulmonary reextension on pulmonary function and oxygen partial pressure in perioperative patients treated with laparotomy under general anesthesia

      摘要
    • 摘要:
      目的分析肺保护性通气联合肺复张对全麻开腹手术病人围手术期肺功能和氧分压（PaO2）的影响。
      方法选取择期行全麻开腹手术的60例病人作为研究对象，并随机分为观察组和对照组，各30例。其中观察组的干预方式是肺保护性通气策略（潮气量6 mL/kg）联合肺复张手法；对照组选择标准通气量（潮气量8 mL/kg）。观察并比较2组气道压、呼吸频率、脉搏血氧饱和度、PaO2、呼气末二氧化碳分压以及并发症发生率。
      结果术中观察组呼吸频率、气道压和呼气末二氧化碳分压高于对照组（P < 0.01）；术后观察组脉搏血氧饱和度、PaO2水平高于对照组（P < 0.01）；术后2组肺功能各指标水平较术前均有所降低，但观察组FEV及FEV1占预计值百分比、FVC及FVC占预计值百分比、FEV1/FVC均优于对照组（P < 0.05~P < 0.01）；观察组并发症率为3.33%，对照组为6.67%，差异无统计学意义（P>0.05）。
      结论肺保护性通气联合肺复张有助于改善全麻开腹手术病人围手术期的肺功能和PaO2，且安全性较高，值得推广应用。

       

      Abstract:
      ObjectiveTo and analyze the effects of pulmonary protective ventilation combined with pulmonary reextension on pulmonary function and oxygen partial pressure (PaO2) during the perioperative period in patients treated with laparotomy under general anesthesia.
      MethodsSixty patients scheduled by laparotomy under general anesthesia from March 2015 to March 2017 were randomly divided into the observation group and control group(30 cases each group).The observation group was treated with lung protective ventilation strategy(tidal volume for 6 mL/kg) combined with pulmonary resuscitation, and the control group was treated with the standard ventilation volume (tidal volume for 8 mL/kg).The airway pressure, respiratory frequency, pulse oxygen saturation(SpO2), PaO2, end-expiratory partial pressure of carbon dioxide(PETCO2) and incidence rate of complications between two groups were compared.
      ResultsThe respiratory frequency, airway pressure and PETCO2 in observation group during operation were higher than those in control group(P < 0.01), and the levels of SpO2 and PaO2 in observation group after operation were higher than those in control group(P < 0.01).The levels of postoperative lung function indexes in two groups decreased compared with before operation, and the predicted value percentage of FEV and FEV1, FVC and FVC, and FEV1/FVC in observation group were better than those in control group(P < 0.05 to P < 0.01).The incidence rate in observation group and control group was 6.67% and 3.33%, respectively, and the difference of which was not statistically significant(P>0.05).
      ConclusionsThe pulmonary protective ventilation combined with pulmonary reextension is helpful to improve perioperative pulmonary function and PaO2 in patients treated with laparotomy under general anesthesia and has safety, which is worthy of popularization and application.

       

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