侧卧位单肺通气1∶1吸呼比对老年患者呼吸动力学及氧合的影响.docVIP

侧卧位单肺通气1∶1吸呼比对老年患者呼吸动力学及氧合的影响 　　【摘要】 目的：探讨侧卧位单肺容量控制通气时，吸呼比1∶1对老年患者呼吸动力学及氧合的影响。方法：选择56例老年开胸患者分成两组，实施容量控制单肺通气吸呼比为1∶1（A组）和1∶2（B组），分别在双肺通气后15 min，单肺通气后30 min及60 min，恢复双肺通气后15 min，记录动静脉血气分析结果和呼吸参数。结果：与B组相比，单肺通气期间A组的气道峰压和气道平台压（cm H2O）的标准差明显偏低（P0.01）；动脉-呼气末二氧化碳分压差明显偏低（P0.01）；而单肺通气期间的动脉氧分压PaO2无明显差异。结论：侧卧位单肺容量控制通气时1∶1吸呼比与1∶2相比能降低气道峰压和气道平台压，改善动态顺应性和肺泡通气效率，但不能实质改善动脉氧合。 　　【关键词】 单肺通气； 吸呼比； 氧合； 呼吸参数 　　【Abstract】 Objective： To investigate the lateral position of single lung ventilation volume control ventilation， call absorption ratio 1∶1 on elderly patients with respiratory dynamics and the influence of oxygen. Method： To choose 56 patients with elderly thoracotomy， randomly divide into 2 groups， the implementation of volume control ventilation， single lung ventilation call absorption ratio of 1∶1 （group A） respectively and 1∶2 （group B）. After the double lung ventilation one-lung ventilation after 15 minutes， 30 minutes and 60 minutes， 15 minutes after the double lung ventilation recovery record arteriovenous blood gas to respectively analyze results and respiratory parameters. Result： Compared with group B， group A during the period of single lung ventilation airway peak pressure and airway platform （cm H2O） standard deviation was significantly lower （P0.01）. Artery-breathe out CO2 partial pressure difference at the end was lower significantly （P0.01）. The arterial oxygen partial pressure during one-lung ventilation PaO2 had no obvious difference. Conclusion： Lateral position of single lung volume control ventilation， compared with the 1∶2， 1∶1 call absorption than lower airway peak pressure and airway platform， improve the dynamic compliance and alveolar ventilation efficiency， but not the essence and improve arterial oxygen. 　　【Key words】 Single lung ventilation； Call absorption ratio； Oxygenation； Respiratory parameters 　　First-author’s address： Rizhao Hospital of Traditional Chinese Medicine， Rizhao 276800， China 　　doi：10.3969/j.issn.1674-4985.2014.25.019 　　低氧血症及