舒芬太尼丙泊酚全凭静脉麻醉对单肺通气肺内分流影响.docVIP

舒芬太尼丙泊酚全凭静脉麻醉对单肺通气肺内分流影响 　　【摘要】 目的 拟观察舒芬太尼-丙泊酚全凭静脉麻醉对单肺通气肺内分流的影响。方法 选择单肺通气(OLV)食管癌手术患者40例,将患者随机分为两组,舒芬太尼-丙泊酚组(S组),异氟醚-芬太尼组(I组),每组20例。S组选择舒芬太尼-丙泊酚全凭静脉麻醉,I组选择异氟醚-芬太尼静吸复合麻醉。分别在双肺通气后15 min(T0),OLV 15 min(T1) ,OLV 30 min(T2),OLV 60 min(T3)及OLV90 min(T4)采集动脉血和混合静脉血行血气分析,并计算肺内分流率(Qs/Qt)。结果 两组患者PaCO2、 pH均在正常范围,组间比较无明显差异;S组单肺通气后各时点PaO2均高于I组(P0.05),Qs/Qt值低于I组。结论 与异氟醚静吸复合麻醉相比,舒芬太尼异丙酚全凭静脉麻醉可减少OVL时的肺内分流,提高动脉氧分压,有利于单肺通气时低氧血症的预防。 　　【关键词】 舒芬太尼;丙泊酚;单肺通气;肺内分流;全凭静脉麻醉 　　 　　Effects of sufenianil-propofol intravenous anesthesia on intrapulmonary shunt during one-lung ventilation 　　LI Ai-xiang, NIU Qiang, MA Chuan-gen,et al. 　　Department of Anesthesiology, Huai-He Hospital,He Nan University,Kaifeng 475000, China. 　　【Abstract】 Objective To observe the effects of sufenianil-propofol intravenous anesthesia on intrapulmonary shunt during one-lung ventilation.Methods Forty ASA I～II patients, undergoing radical esophagus cancer with one-lung ventilation were selected and randomly divided into sufenianil-propofol group (group S) and isoflurane - fentanyl group(group I). Group Sreceived sufenianil-propofol intravenous anesthesia; Group I received isoflurane - fentanyl combined anesthesia. Arterial and mixed venous blood gases were analyzed at 15 min after TVL(T0),15 min,30 min,60 min,90 min after one-lung ventilation(T1、T2、T3、 T4)and the intrapulmonary shut fraction (Qs/Qt)were calculated. Results (1) PaCO2 and pH in two groups were normal, there were no significant diference between two groups.(2) The levels of Qs/Qt all increased during OLV at every time point after OLV, The levels of Qs/Qt in group S were lower, and paO2 were higer than those in group I .Conclusion Compared with isoflurane - fentanyl combined anesthesia , Sufenianil-propofol intravenous anesthesia can decrease intrapulmonary shunt and improve the levels of paO2 during one-lung ventilation, and it’s profit for the prevent of hypoxemia. 　　【Key words】 Sufenianil;Propofol;One-Lung Ventilation;Intrapulmonary Shunt;Intraven