| 开胸手术中术侧肺部分通气对肺内分流的影响 |
| 投稿时间：2014-09-03 修订日期：2014-09-16 点此下载全文 |
| 引用本文：赵宇鹏,窦忠琴,陆慧红,白浪,王清秀,李桂凤.开胸手术中术侧肺部分通气对肺内分流的影响[J].医学研究杂志,2015,44(3):104-107 |
| DOI：
10.3969/j.issn.1673-548X.2015.03.029 |
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| 中文摘要:目的 探讨开胸手术时应用术侧肺部分通气法对肺内分流及氧合的影响。方法 择期行左侧开胸食管癌手术的患者16例, ASAⅠ~Ⅱ级, 采用数字表法随机分为两组, 进行自身对照交叉研究。在双肺通气(TLV)后两组按不同顺序接受单肺通气(OLV)和术侧肺部分通气(PLV), 各通气30min。于TLV、OLV 和PLV后各30min等时点取动脉血和右心房静脉血, 记录动脉血氧分压, 并计算肺内分流率(Qs/Qt)。结果 与OLV时比较, PLV时气道峰压Ppeak显著降低(t=3.712, P=0.009);平台压Pplat显著降低(t=4.124, P=0.016);动脉氧分压则明显增加(t=126.982, P=0.000);Qs/Qt显著减少(t=9.875, P=0.000)。结论 开胸手术中行术侧肺部分通气可减少肺内分流, 显著改善氧合。 |
| 中文关键词:单肺通气 肺内分流 开胸手术 |
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| Effect of Partial Ventilation of Independent Lung on Intrapulmonary Shunt during Thoractomy |
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| Abstract:Objective To study the effect of partial-lung(independent lung) ventilation(PLV) on oxygenation and Intrapulmonary shunt during thoracotomy. Methods Sixteen ASAⅠ-Ⅱ esophagus patients were randomized divided into two groups and a self-controlled cross-over study was used. Two types of ventilation(OLV and PLV) were used in different sequence after two-lung ventilation(TLV). Arterial and mixed venous blood samples were taken for blood gas analysis after TLV, OLV and PLV for 30 min respectively and intrapulmonary shunt (Qs/Qt) was calculated. Results Compared with OLV, after PLV, Ppeak decreased significantly (t=3.712, P=0.009), Pplat decreased significantly (t=4.124, P=0.016), PaO2 increased significantly (t=126.982, P=0.000), and Qs/Qt decreased significantly (t=9.875, P=0.000). Conclusion PLV significantly decreases Qs/Qt and improve oxygenation during thoracotomy. |
| keywords:Onelung ventilation Intrapulmonary shunt Thoracotomy |
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