全身麻醉不同潮气量对俯卧位手术患者血清中CC16表达的影响

目的探讨全身麻醉不同潮气量对俯卧位手术患者血清中CC16表达的影响。方法将行俯卧位脊柱全身麻醉手术患者80例完全随机分为4组，每组20例。另选20例在硬膜外麻醉下行俯卧位手术的患者为对照组。I组设定潮气量12ml／kg，呼吸频率8次／min；Ⅱ组潮气量10ml／kg，呼吸频率100次／min；Ⅲ组潮气量8mL／kg，呼吸频率12~．／min；IV组潮气量6ml／kg，呼吸频率14次／min。手术开始前及结束后抽取静脉血2ml送检，采用双抗体两步夹心酶联免疫吸附法测定CC16含量。结果Ⅰ、Ⅳ组术后CCl6低于本组术前及对照组术后[I组：（34±15）mg／L比（40±16）、（40±15）mg／L；Ⅳ组：（33±16）mg／L比（40±16）、（40±15）mg／L；均P〈0．05]，Ⅱ、Ⅲ组术后CC16与本组术前及对照组术后比较差异无统计学意义[Ⅱ组：（414-16）mg／L比（42±16）、（40±15）me／L；III组：（40±17）mg（L比（40±16）、（40±15）μg／ml；均P〉0．05]。结论全身麻醉俯卧位手术患者在间歇正压通气模式下设定潮气量8ml／kg、呼吸频率12次／min时，CCl6手术前后变化最小，该组通气模式对肺脏损伤最小，有利于围手术期肺脏保护。

Effect of different tide volume on serum CC16 concentration in patients undergoing general anesthesia surgery

Objective To investigate the effect of different tide volume on serum clara cell secretary protein （CC16） concentration in patients undergoing general anesthesia in prone position. Methods All 80 patients underwent spinal surgery in general anesthesia were randomly divided into four groups and each group of 20 cases. tidal volume of patients in group I was 12 ml/kg, breathing rate was 8 times/min; tidal volume was 10 ml/kg and breathing rate was 10 times/min in group II; tidal volume was 8 ml/kg, breathing rate was 12 times/min in group m; tidal volume was 6 ml/kg and breathing rate was 14 times/rain in group IV. 20 cases underwent operation of a prone position in the epidural anesthesia as a control group. The serum concentration of CC16 was measured by enzymelinked immunoadsorption before operation and postoperation. Results Postoperative serum concentration af CC16 in group I and group IV was significant lower than preoperative serum concentration of CC16, and postoperative in control group [group h （34 ± 15）mg/L vs （40 ± 16）, （40 ± 15）mg/L; group IV： （33 ± 16）mg/L vs （40 ±16）, （40 ± 15） mg/L; all P 〈0. 05]. The serum concentration of CC16 in group Ⅱ and group Ⅲwas no significant compared with preoperative serum concentration of CC16, and postoperative in control group [group II： （41 ± 16）mg/L vs （42：1： 16）, （40 ± 15 ） mg/L; group 111 ： （40 ± 17 ） mg/L vs （40 ± 16 ）, （ 40 ± 15 ） mg/L; all P 〉 0.05 ]. Conclusions The most suitable ventilation modes for surgery patients on prone position during general anesthesia is tidal volume 8 ml/kg and breathing rate 12 times/min. The changes of CC16 is minimum before and after operation and the ventilation modes with minimum damage should be helpful for perioperative lung protection.