肺病护理论文外科手术保护性肺通气在俯卧位手术中的应用[精品论文].doc

肺病护理论文外科手术论文:
保护性肺通气在俯卧位手术中的应用
【摘要】目的观察小潮气量联合低水平呼气末正压(PEEP)对俯卧位手术患者氧合的影响。方法对50例ASAⅠ或Ⅱ级,择期在全麻下行胸腰椎手术患者,随机均分为两组,研究组A组使用保护性肺通气模式,VT=6 ml/kg,PEEP=5 cm H2O。对照组B组使用常规机械通气模式,VT=10 ml/kg,分别监测麻醉前(T1)、 h后(T2)、 h(T3)时的动脉血氧分压(PaO2)和术中的气道峰压(Ppeak)的变化,并计算氧合指数[PaO2/吸入氧浓度(FiO2)]的值。结果与B组比较,A组在T3时的PaO2、PaO2/FiO2显著提高(P<)。结论保护性肺通气模式有助于改善俯卧位手术患者术后氧合。
【关键词】保护性肺通气;俯卧位;氧合
The use of lung protective ventilation in prone position surgery
HUANG Juan-juan,FANG of Anesthesiology,the 98th Hospital of PLA,Huzhou 313000,China
【Abstract】 Objective To investigate the effects of lower-tidal volume and low level of PEEP in patients undergoing prone position surgery on Fifty patients,ASAⅠorⅡ,undergoing spina were randomly assigned to two groups,the study group(group A)was ventilated with lung-protective ventilation strategy(VT=6 ml/kg,PEEP=5 cm H2O).The control group(group B)was ventilated with conventional strategy(VT=10 ml/kg).The effect of different time[Before anesthesiology(T1),After hour in the prone position(T2),After tracheal extubation(T3)]on partial pressure of oxygen in artery(PaO2)and Peak airway pressure(Ppeak)were 2/inhaled oxygen concentration(FiO2)was with group B,PaO2,PaO2/FiO2 at T3 in group A was increased significantly(P<).Conclusion Lung-protective vent