高频喷射通气辅助单肺通气在Ⅰ型呼吸衰竭患者胸科手术中的应用 |
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引用本文: | 王维,何柳,隋波,李永旺,李冠华,马涛.高频喷射通气辅助单肺通气在Ⅰ型呼吸衰竭患者胸科手术中的应用[J].医学临床研究,2012(9):1658-1660. |
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作者姓名: | 王维 何柳 隋波 李永旺 李冠华 马涛 |
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作者单位: | [1]第二炮兵总医院麻醉科,北京100088 [2]解放军第316医院检验科,北京100093 |
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摘 要: | 【目的】探讨单肺通气(OLV)中非通气侧肺高频喷射通气(HFJV)在I型呼吸衰竭患者中的作用。【方法】选择合并I型呼吸衰竭全麻单肺通气胸科手术患者34例,随机分为两组,每组17例,全麻快速诱导后插入双腔支气管导管,HFJV组(H组)单肺通气后非通气侧肺行HFJV;对照组(C组)行单肺通气。分别于麻醉前(T0)及0LV前(T1)、OLV后10min(T2)、30min(T3)、60min(T4)、术毕恢复双肺通气后10min(T5)行血气分析,计算肺内分流率肺内分流量/心输出量(Qs/Qt)],同时监测气道压力并计算肺顺应性(Cdyn)。【结果】C组有4例患者由于严重低氧血症退出该研究;与T,时比较,Tz~Ta时两组PaO2均下降,Qs/Qt、气道峰压(Pmax)升高、Cdvn下降(P〈0.05);与C组比较,H组Tz~Tt时Paoz显著增高、Qs/Qt显著降低,其差异均有统计学意义(P〈0.05),Pmax、Cm无显著性差异(P〉0.05)。【结论】高频喷射通气辅助单肺通气可降低I型呼吸衰竭患者肺内分流,维持较好的PaO2。
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关 键 词: | 高频喷射通气 方法 呼吸功能不全 外科学 |
Application of HFJV Assisted OLV in Patients with Type 1 Respiratory Failure Undergoing Tho- racic Surgery |
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Affiliation: | WANG Wei, HE Liu, SUI Bo ,et al ( Department of Anesthesiology, General Hospital of Second Artillery Army, Beijing 100088,China ) |
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Abstract: | Objective]Objective]To explore the role of high-frequency jet ventilation(HFJV) of non-ventilation lung during one-lung ventilation(OLV) in patients with type I respiratory failure. Methods] Thirty four patients with type I respiratory failure undergoing OLV were randomly divided into two groups with 17 cases in each group. After induction of anesthesia, a double-lumen endotracheal tube was introduced. HFJV group(group H) underwent HFJV of non-ventilation lung after OLV. Control group(group C) underwent OLV. Blood gas analysis was taken be- fore anesthesia(T0), before OLV(T1 ), at 10min(T2 ), 30min(T3 ) and 60rain after OLV(T4 ) and 10rain after two lung ventilation(T5 ). Intrapulmonary shunt volume/cardiac output (Qs/Qt) was calculated. Airway pressure and lung compliance(Cap,) were monitored. Results]Four patients in group C quitted the research because of severe hy- poxemia. Compared with T1, PaO2 and Cdyn at T2 -T4 decreased( P 〈0.05), while Qs/Qt and maximum airway pressure(Pin.x) increased( P 〈0.05). Compared with group C, PaO2 in group H at T2 -T4 markedly increased, while Qs/Qt markedly decreased, and there was significant difference( P 〈0.05). There was no significant differenee in Cayn and Pmax ( P 〉0.05). Conclusion] HFJV assisted OLV can decrease Qs/Qt and maintain a better PaO2 in patients with type I respiratory failure. |
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Keywords: | High-frequency jet ventilation/MT respiratory insufficiency/SU |
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