[1]王晓娟,秦 岭△,韩 明.压力控制容量保证通气模式对腹腔镜直肠癌根治术老年患者呼吸力学的影响*[J].陕西医学杂志,2019,(8):1003-1005，1027.
　WANG Xiaojuan,QIN Ling,HAN Ming..Application of pressure-controlled ventilation-volume guaranteed mode in laparoscopic  rectal carcinoma radical resection[J].,2019,(8):1003-1005，1027.
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压力控制容量保证通气模式对腹腔镜直肠癌根治术老年患者呼吸力学的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1003-1005，1027
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Application of pressure-controlled ventilation-volume guaranteed mode in laparoscopic  rectal carcinoma radical resection
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.012
作者:
王晓娟1; 秦 岭2△; 韩 明
1.陕西省渭南市妇幼保健院麻醉科(渭南714000）；2.陕西省渭南市妇幼保健院普外科(渭南714000）
Author(s):
WANG Xiaojuan;  QIN Ling; HAN Ming.
Department of Anesthesiology,  Weinan Maternal and Child Health Hospital in Shaanxi Province（Weinan 714000）
关键词:
容量控制通气模式; 压力控制容量保证通气模式; 老年人; 腹腔镜直肠癌根治术; 呼吸力学;  血流动力学
Keywords:
Key words Volume-controlled ventilation;  Pressure-controlled ventilation-volume guaranteed;  Aged;  〖LM〗Laparoscopic rectal carcinoma radical resection;  Respiratory mechanics;  Hemodynamics
分类号:
R614.2
文献标志码:
A
摘要:
摘 要 目的：比较压力控制容量保证通气 (PCV-VG)和容量控制通气（VCV）模式对择期全麻下行腹腔镜直肠癌根治术的老年患者术中血流动力学、血气分析、呼吸力学指标的影响。方法：择期行腹腔镜下直肠癌根治术老年患者80例，年龄65～80岁。采用随机数字表法分为两组,PCV-VG组40例,VCV组40例。记录麻醉诱导前（T0）、气管插管后 10 min（T1）、气腹低头位后60 min（T2）、气腹解除平卧位后10 min（T3）、清醒拔管后5 min（T4）的平均动脉压（MAP）、心率（HR），同时记录和计算T1、T2、T3时的动脉氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、肺动态顺应性（Cdyn）、气道平台压（Pplat）、气道峰压（Ppeak）。结果：两组患者PaO2在T2时间点低于T1、T3，差异有统计学意义（P＜0.05）；两组患者T2时Cdyn低于T1、T3，而Pplat、Ppeak高于T1、T3，差异有统计学意义（P＜0.05）；PCV-VG组T2时Cdyn高于VCV组，而Pplat、Ppeak低于VCV组，差异有统计学意义（P＜0.05）。两组患者在各时点的HR、MAP差异无统计学意义（P>0.05）。结论：与VCV相比，PCV-VG 能够有效提高行腹腔镜直肠癌根治术老年患者术中动态肺顺应性，降低气道平台压和气道峰压，改善氧合，从而降低机械性肺损伤的风险。
Abstract:
Abstract Objective：To observe the different effects of PCV-VG mode and VCV mode on hemodynamic，blood gas analysis and respiratory mechanics in patients undergoing laparoscopic rectal carcinoma radical resection. Methods:80 cases of patients undergoing laparoscopic rectal carcinoma radical resection were randomly allocated into 2 groups (n=40 each) using a random number table：pressure-controlled ventilation-volume guaranteed (group PCV-VG) and volume-controlled ventilation (group VCV). The mean arterial pressure（MAP）, heart rate（HR）were recorded before induction of anesthesia without oxygen inhalation（T0），10 min after tracheal intubation（T1）, 60 min after pneumoperitoneumin Trendelenburg position（T2）, 5min after close the pneumoperitoneum in supine position（T3） and 5min after extubation（T4）. Arterial partial pressure of oxygen（PaO2）, arterial partial pressure of carbondioxide（PaCO2）were recorded. The thoracic compliance（Cdyn），plateau pressure（Pplat）, peak airway pressure（Ppeak）were recorded and also calculated at T1,T2,T3. Results:The PaO2 at T2 were lower than T1,T3 in both group, the difference was statistically significant(P＜0.05);the Cdyn at T2 were lower than T1,T3 in both groups, the difference was statistically significant (P＜0.05) ,the P plat,P peak at T2 were higher than T1,T3 in both groups (P＜0.05);the Cdyn in group PCV-VG at T2 was higher than group VCV (P＜0.05), the P plat, P peak in group PCV-VG at T2 was lower than group VCV (P＜0.05).There were no obvious differences between the two groups of patients’ HR, MAP in every time point(P>0.05). Conclusion：Compared with VCV,PCV-VG can effectively enhance thoracic compliance,lower the airway plateau pressure and peak pressure, improve arterial oxygenation and gas exchange and decrease the risk of lung injury after mechanical ventilation in patients undergoing laparoscopic rectal carcinoma radical resection.

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备注/Memo

备注/Memo:
*陕西省渭南市科研发展计划项目(社发攻关) (2015KYS-1-1)
更新日期/Last Update: 2019-08-13